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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client l"NESME Y e'OA/SaLT/A/y Phone e�� 9- /7 0 S <br /> Address P.o Coy 7 7JA <br /> _ CC to: <br /> I U c i o U, rA Zip <br /> i <br /> Signature of person authorizing work _— <br /> under terms stated below' ), 2> <br /> 'Net 30 days. All accounts past due will be subject to Interest charges of 1.5% per month, <br /> 'Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID ANALYSIS <br /> oof Cw <br /> Con <br /> SAMPLi BY: (sl re): lain \ +�� <br /> ers !' REMARKS <br /> sample <br /> h� `�w <br /> typ8 Sample Location <br /> Date Time <br /> 12 <br /> 9 Z1 rgd" r. <br /> ')T7 4S r /(JFT y v <br /> 5,=f T 20 t r x <br /> Z5- 6 T V 4. <br /> Rehn sh by(signature), D/yate ; Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature) Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish. Total Hours. Start: Finish: Total Hours. <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />