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Client 1( <br />Address <br />K(q (o d.5'1,1 1\." <br />y 37 '14 <br />Phone <br />CC to. <br />A & L WESTERN LABORATORIES, INC. <br />1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br />CHAIN OF CUSTODY <br />tifR 01-1/ C A zip <br />, <br />Signature of person authorizing work <br />under terms stated below• /01eil tralf-M/1_-/2--1 <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 Noof. . <br />tain- <br />ANALYSIS <br />REMARKS <br />SAMpLED BY: g ature): <br />samOle <br />tY Pe Sample Location Date Time Gmb Comp. <br />I4 - OW),1 \ — ..<:, t) - ter, _ I ),. y <br />/ <br />7 <br />Relin ished by (s,igip7): Date <br />i ' . 1 3 7 <br />Time <br />:7' .. ; 0 <br />Received by (signatu e): <br /> <br />.2- ._---( <br /> <br />?/2 ,--- ..„. _._, <br />Date <br />, -,. ,.- _ /:/ <br />Time <br />, <br />, 7 <br />Relinquished by (signature): Date Time Reccved 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: <br />Start: Finish: Total Hours: <br />Driving Time: <br />Start: Finish: Total Hours: <br />Dedicated Exclusively to Providing Quality Analytical Services