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_.� <br />.. , ., „i:p'. .'�'9A:':l'�='��4Ei+C:y?Z±: T:d•;4m, rtAacpr <br />A & L WESTERN LABORATORIES, INC. <br />1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br />CHAIN OF CUSTODY <br />Client t/ LQAJ 22'7_/,Al�� Phone r5l f9 7 -- X02 - 4� 5_2 <br />Address 1P • 0 Pr)X 24 CC to: <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 <br />NoANALYSIS1�� of <br />Con - <br />fain- <br />ers <br />2� <br />� <br />REMARKS <br />SA D BY: ature): <br />sample <br />type ample Location <br />Date Time crap Como. <br />q oiyo <br />3 F2,r <br />I <br />X <- <br />v Pa -t P f --r <br />_ <br />y <br />q r T <br />X <br />Relinils ed by (s' n re): <br />f v— <br />7 t <br />//`�% <br />Time <br />%dab <br />Rel%4ed (sig/atur <br />f G' <br />Date <br />%f>Z <br />Time <br />�i.•'.�: <br />Relinquished b Ignature): <br />Date <br />Time <br />Receive by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time r <br />Site Time: <br />Start: Finish: <br />Total Hours: <br />Driving Time: <br />Start: Finish: <br />Total Hours: <br />Dedicated Exclusively to Providing Quality Analytical Services <br />