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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 e Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client C�l F S Nr AJ!i'NSLl i A,/('I' Phone L" t/,- <br /> Address �' iOX `. 7-7zl CC to: <br /> 'u r�Z- 0' � r�1 Zip 9-'7 o <br /> Signature of person authorizing work <br /> under terms stated below' 1� i <br /> 'Net 30 days. All accounts past due will be subject to interest ch rges 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 /> � x No. <br /> V�/D�IL � ;L/D Co- ���� <br /> SAMPL BY: (si re): twin- <br /> ers �4 REMARKS <br /> sample <br /> type Sample Location Uv <br /> Date Time G.ab comp. <br /> � <br /> 3611 <br /> ? K <br /> I ;J -T <br /> Relinis ed by(si ): Date Time Re ved by(signature): Date Time <br /> Relinquished by(signature): Date Time Re Oived 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 />