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A & L WESTERN LABORATORIES, INC. <br /> 4k 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-1080 <br /> /+ CHAIN OF CUSTODY / <br /> Client L�✓E�IU�t/ [�..�11ij 1 <br /> L -A14 Phone ('/?�i"�Y/^'/W <br /> Address - C) ' F'[y T' -79r! _.___....._.._._ CC to: <br /> f/.l !1 II zip <br /> �.. (5 ! — <br /> Signature of person authorizing work <br /> under terms stated below' <br /> -Net 30 days. All accounts past due will be subject to interest c arges 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 No ANALYSIS <br /> ofCon , V�,. <br /> SAM ED BY:/(� ,mature)`. ern <br /> REMARKS <br /> sampe <br /> le � --- <br /> type ample Location <br /> Date Time ,,, tomo. <br /> Relinq sh dby(si r ): Dto Time Received by(signature): Date Time <br /> r <br /> Relinquished by(signature): Date Time Receivedby(signature): Date Time <br /> Relinquished by(signature): Date Time Received by 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: I <br /> Start, Fimish'. Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Serv' es <br />