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Ail A & L WESTERN LABORATORIES, INC. <br /> ' 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> WNIPJP.LL EMARUVwEM4 MWSiPW " <br /> CHAIN OF CUSTODY <br /> Client &/r5 X MEf/ (`J.L", Phone <br /> Address F' U _"y � <br /> �/� r CC to: <br /> IZLUC!<. r !"/�-! 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 rges 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 /> / 1"V C'7 co- <br /> SA BY: si nature): jai"' F" h <br /> �, ers +,/ ��- U �� REMARKS <br /> + <br /> sample <br /> type Sample Location \ <br /> Date Time Grab comp. <br /> �iz7 1, ✓ <br /> Ir ! j y <br /> u� 777 V �L X K <br /> Rely'. Sshed by( g ure): Bate 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 /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />