Laserfiche WebLink
�4 A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> . FivIAONr.EMn <br /> CHAIN OF CUSTODY <br /> Kv z 1 G52client <br /> Address K > 9 r CC to: <br /> Zip <br /> Signature of person authorizing work <br /> under terms stated below' Lie, <br /> 'Net 30 days. All accounts past due will be subject to interest cfiarges 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 /> PROJECTID ( <br /> hh No. <br /> 7 tl lJA of <br /> Con- <br /> SAMPLED BY: ($+gnature): tain• r. <br /> ers rr�/ REMARKS <br /> sample <br /> type Sample Location <br /> Date Time Grab comp, <br /> rr <br /> Relin fished by(si riat"re): ate Time Receed by(signatyr�): j Date Time <br /> f/4�U�I4� <br /> Relinquished by(s •nature): Date Time Received by(signature): Date Time <br /> r <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 />