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A & L WESTERN LABORXrORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> Auccoma <br /> CHAIN OF CUSTODY <br /> Client /U� �/V jL( Le/i�l� <br /> ,/ Phone <br /> Address ��-74 CC to: <br /> 1,A zip <br /> Signature of person authorizing work / 7 <br /> under terms stated below' �Gt (��✓�� / (t�i<,� _ <br /> 'Net 30 days. All accounts past due will be subject to interest charges 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/,e- <br /> _Alf%1,4 AJ of . <br /> Con- <br /> SAMP QED.BY: (signature): tars +� <br /> `t r REMARKS <br /> C is <br /> sample <br /> type Sample Location <br /> Date Time G,ab 1--1. <br /> � y <br /> Rel i µ{shed b Ts ture): Gate k13 <br /> me Received by(signature): Date Time <br /> fr L Relinquished by(signature): Dateme 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 />