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' A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> Af�CYWR,LL.ENHYOEw(NGy.iNW51iW <br /> CHAIN OF CUSTODY <br /> Client �1 V '_ t ('19AlS LfL zJG�— Z _ <br /> /�/� Phone l! 2 <br /> Address P K Z 7 -1 CC to: <br /> JA, Zip <br /> Signature of person authorizing work /1 <br /> under terms stated below' mit 'y <br /> 'Net 30 days. All accounts past due will be subject to interest arges 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 /> SAME ) c t /� ANALYSIS <br /> L/v A 7- of <br /> Y�.si ature): Con- <br /> , ii - it <br /> ers <br /> REMARKS <br /> sample , "� _',. <br /> Date Time type Sample Location Al <br /> Grab Comp. <br /> 7 T <br /> V, 1( <br /> R i nquished fs jgnature): <br /> Date, Time Igeived by(signatur at Time <br /> Relinquished by(signature. Date Time Received by(signature): 1 <br /> Date Time <br /> Relinquished by(signature): Date Time Received by(signature): <br /> Date Time <br /> Relinquished by(signature): Date Time Received by(signature): <br /> Date Time <br /> Relinquished by(signature): Date Time Received by(signature): <br /> Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: <br /> Finish: Total Hours: <br /> I <br /> Dedicated Exclusively to Providing Quality Analytical Services <br /> i <br />