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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 * Modesto, California 95351 o Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client 6, <br /> Phone <br /> !7 A <br /> Address CC to: <br /> Zip <br /> Signature of person authorizing work" <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 /> SAMPLED BY: (signature): tain- <br /> ers <br /> REMARKS <br /> sample <br /> "P. <br /> Date Time Grab Como. <br /> Sample Location <br /> Relinquished by(signature): [)ate, 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 /> 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 />