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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> �Ia <br /> CHAIN OF CUSTODY <br /> Client E11-i ��P�f(� � ?P��i/L irl Phone � D . <br /> Address �� - �/ f� r J k � / 7� CC to: <br /> 11 (.ter,.',' —zip n <br /> Signature of person authorizing work <br /> under terms stated below''-t'` <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 <br /> No. <br /> o1 <br /> Corr ^tir <br /> SAMPLP BY: (signature): Iain- ti- <br /> t-1 ?/:_1✓�'I. ers REMARKS <br /> s le / <br /> type Sample Location <br /> Date Time o.p ten. <br /> Relinquished is I gnature): patre Time Wed by(sigrlature): Date Time <br /> t. <br /> Ji <br /> Relinquishe& 6y(signature): j 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 /> i <br />