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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client 6_Qd 3,17-//A1(_2 Phone z< y- 02 - /( , <br /> Address P • O P rIX �2 2. 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 ch es 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 V NoANALYSIS1�� of 2� <br /> Con- <br /> SA D BY: ature): fain- � <br /> ers REMARKS <br /> sample <br /> type ample Location <br /> Date Time crap Como. <br /> q oiyo3 F2,r I X a -r P f-r <br /> _ y <br /> " r T X <br /> Relinlls ed by(s' n re): 7 t Time Rel%4ed (sig at Date Time <br /> y, P <br /> Relinquished b Ignature): Date Time Receive 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 v%,,. <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />