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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client C �r< S/NJ y ��/U�(�!%/N� Phone C�6g <br /> Address 7`I _ CC to: <br /> /<�('fl Zip (T S t <br /> Signature of person authorizing work <br /> under terms stated below' »>LLL <br /> 'Net 30 days. All accounts past due will be subject to interest harges 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 /> Wo�l/ A N L� of <br /> Con- ^ <br /> SAMPLI�D BY: (Sig ): tain- <br /> J ers c�h REMARKS <br /> 4 i <br /> sample <br /> 1ype Sample Location 3 <br /> Date Time 1, <br /> ab —, <br /> 7US n/. <br /> 27 /ATF < �TfClL. <br /> Rel�[ushed by lure): gate Time RP ived by(signature): Date Time <br /> m <br /> 607 <br /> Relinquished by(signature): Date Time Re eived 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 />