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A & L WESTERN LABORATORIES, INC. <br />1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-5294080 <br />CHAIN OF CUSTODY <br />Client ((-1/L-i 4;10 r_ /c1 til( <br />Address F. 4(»( 37c1A <br />.e._. Zip <br />Signature of person authorizing work <br />( under terms stated below* <br />Phone :09- ziO - <br />CC to. <br /> <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. <br />tain- <br />ers <br />ANALYSIS i <br />\ \ N <br />REMARKS <br />1 . / i <br />r <br />SAMP D ByLli(sffi._ Jyature): <br />sample <br />type &mple Location <br />Date Time Grab Coon). <br />AV2 I Ogie, Z 5 / / Y V Y i( <br />4 L'i5.4 Y. t/. // 1 .„‹ , ,X y <br />4 1 0.g.k x' L I_ el.41 / ,, \ct X <br />Kv ••,, v <br />ill .,,E,/,) . v‘5 / ' i v y x. y <br />.A /-) ' (42-c \,/ k I -4 i i ‘,., %:. >(.. <br />, ---- <br />Re • 'qUished b (si re): te Time Received*(signatu e): ,-- Date Time <br />. <br />Re inquished; y (signature): / <br />i <br />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 />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