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w•�sw..r - S'S,`+'.:�':' ." .- ,. .,vv-r.;�wn�r.• �'ix.,n�^..rsiaiw:... -. ,. -- .- - - ,.,. <br /> -=A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client.�L7 E �6�J y COA15MZ TlAJi!Z Phone <br /> Address_ P 0 �' X 3 f�� - - .. ..._-- CC to: <br /> u 12 LO c lC zip <br /> Signature of person authorizing work <br /> under terms stated below" h <br /> 'Net 30 days. All accounts past due will be subject to interecharges of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The cl' nt is responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> �.A <br /> PROJECT IDNo ANALYSIS <br /> Cf 1 ALO SIv�G�`7R <br /> o - <br /> cn <br /> SAMPL BY: 3W' ,A'V- 1V <br /> ' ture): leis. <br /> REMARKS <br /> sample � <br /> hype Sample Location <br /> Date Time a.aa tomo. � <br /> 37/T 1630 St-PT 1[ TAN 1 <br /> I. <br /> R;e fished 2nature): D to Time ReCei ed by(signature): Date Time <br /> Relinquished by(signature): ate Time Re eived 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 /> 1 <br />