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A & L WESTERN LABORATORIES, INC. <br /> M 1311 Woodland Ave. #1 a Modesto, California 95351 • Phone 209-5294080 <br /> •WKWMI.I INNMONrrENW wW514A1 <br /> CHAIN OF CUSTODY <br /> Chert - Phone <br /> Address k <br /> CC to: <br /> Zip <br /> rt - <br /> Signature of person authorizing work i <br /> P <br /> under terms stated below' <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 No. ANALYSIS <br /> of <br /> Con- <br /> SAMPLER BY: (signature): twin- <br /> ers REMARKS <br /> sample �J... <br /> type Sample Location <br /> Date Time Grab corny. <br /> J r a <br /> RelingUished by(signature): Date, Time Received by(signat ufpe): Date Time <br /> Relinquished by(s'rgnaturej: Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquisned 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 />