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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 Crl l—�--s/U E 7IA14 <br /> / r3 J -- Phone �� �- (4 03 <br /> Address /'' � - �OX �I.7�f CC to: <br /> TaQLo,-4 CA Zip LV I <br /> Signature of person authorizing work <br /> under terms stated below' a��Z'I <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 j� No ANALYSIS <br /> G 'UE27.4 of <br /> Con- Q <br /> SAMP ' D BY: ( ture): tars (� <br /> ��- REMARKS <br /> sample �� L <br /> type Sample Location <br /> Date Time c ao c— <br /> � DsClI-75 <br /> 95� . ,¢l -vN IZD. /12-12 FWLA/ES D �L- <br /> Re u' hed by(�i re): �at 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 />