Laserfiche WebLink
@ffDLA & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY ©3 I n( Qil 2 <br /> Client--1r WX <br /> �'' 7'IA1L� Phone (�1/"' 407 <br /> Address J" �� 4 CC to: <br /> TuQWCX 1. 64 ZipS- <br /> Signature of person authorizing work Gff <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest c ges of 1.5% per month. / f f <br /> 'Hazardous materials are the property of the client. The client responsible for proper disposal of hazardous wastes. (.cllents not <br /> picking up hazardous wastes may be assessed an appropriate fee. , <br /> nr <br /> PROJECT IDa ANALYSIS j <br /> 57 <br /> T. f3,6r2NAR05- of / <br /> Con. r <br /> SAMPL BY: (Sure): lain. <br /> ers t RF{ ARKS <br /> sty le <br /> Date Time i iSample Location h�\y - <br /> m.o s comp. <br /> V&11 QAFAeg soil t " c� 5 <br /> Y: o y IMP X .¢rt P A 2 <br /> 7:40 SMP e, 11 Dierrg Fpom Pir a <br /> 24 1:55 5 CJ X Dr <br /> I <br /> Relin hedby( ' e): DDto Time ,Jrive by(signatture): Leat Time <br /> /S U (' t^ l4Z <br /> Relinquished y(signature): Date Time R eived by(signature): Date Time <br /> Relinquished by(signature) i -� Date Timej Received by(signature); Date Time <br /> { <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 /> Stan: Finish: Total Hours: Start: Finish:- Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />