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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client of=Sh'r (Z r"�JS(/L j/411? Phone x/07 —4�5-2. <br /> Address P Q • 01C79Ft CC to: <br /> TuR L DC L-1 /Azip 1 f3pz/ <br /> Signature of person authorizing work --- <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest c 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 No ANALYSIS <br /> D E/V/TG of (� <br /> Com <br /> SAMP BY: (si ure): taim <br /> ers <br /> REMARKS <br /> atm le <br /> fv�° Sample Location <br /> Date Time c� <br /> LLL S! 1 t7 0 x% <br /> rz T < CLL <br /> Relinq sed by(s' natp1'e): Date Time Raeeived by(signature): IDa <br /> Time <br /> 56— <br /> Relinquished Dy�(signature): Date Time Received by(signature): Time <br /> Relinquished by(signature): Date Time Received by(signature): 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 />