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AtL <br /> A -& L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client VA "A,, " ' e.4 R CP Phone �/G��-1.67 � <br /> Address CC to: <br /> Zip <br /> Signature of person authorizing work ��.f/-�'c c� -- <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest charges of 1.5% per month. Z l <br /> 'Hazardous materials are the property of the client. The client is responsible for proper dispospi,othazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. r (; <br /> J t <br /> P,{ROJECT ID r No ANALYSISof <br /> Con- <br /> SAMPL tain- <br /> BY: (si fore): ers ' , r� �tj REMARKS <br /> sample <br /> type Sample Location <br /> Date f� <br /> Time � <br /> GraO Comb <br /> tt � i w I- r- <br /> y <br /> K v x X X <br /> Relin i hed by p ture): Date Time Received'by(si ,n�re. D to Time <br /> 1" / �/'',V� f I 0/ 103r <br /> Relinquished by(signature): Date Time Received by :(sl nature to Time <br /> t <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 />