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&=s A & L WESTERN LABORATORIES, INC. <br /> - t 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> d �c+Kian�.0.araawww.wuswa <br /> CHAIN OF CUSTODY <br /> Client Phone <br /> Address 1 n - 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 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 /> All�/ L �/ Con <br /> SAM D BY: ' ature): hers <br /> ( sj y� `/� REMARKS <br /> I', le <br /> type Sample Location <br /> Date Time GnD carp. <br /> 60 xlyc ; <br /> i <br /> Reftgqu shed 4by' nature): Date Time Recei e by(srgnatu/rrs): i'/! Date Time <br /> Re <br /> quishe, y(signature): Dae Time Receiv0d 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: Finist.: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />