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A & L WESTERN LABORATORIES, INC. <br /> 131.1 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529.4080 <br /> CHAIN OF CUSTODY <br /> Client r E W�`�SU LT/AJ Phone __W116 <br /> 7V CC to:i <br /> Address y/ /Limit:.� <br /> T/^.[moi./ CA _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 char es of 1-51/o per month. <br /> 'Hazardous materials are the property of the client. The client is responsible for proper d osal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. P~ <br /> PROJECTof <br /> } ID Iva <br /> AANALYSIS }� <br /> 49CI- A �� Con- <br /> SAMPLBY: (5i ) tain- <br /> ars <br /> .a�Q REMARKS <br /> same-Te <br /> type Sample Location / 1 <br /> Date Time Grab comp. <br /> rix <br /> o P E Lo r <br /> i <br /> Relin i hed by(s' ): i Time Recived by(signature): Date Time <br /> Relinquished by(signature); Date Time Received.by(signature): Date. Time.. . <br /> Relihquished by::(signatuYe) Date., Tirne Received by(signature): <br /> Date Time <br /> Relinquished by.(signature): Date.. Time Received by(sjgnature): Date ' Time; <br /> Relinquished by,-(signature)` Date Time Received by(signature): Date Time <br /> Site Time Driving Time <br /> Start: Ftnish: - Total:Hours: Start: _ Finishir Total Hours- <br /> -Dedicated Ex&lbsive.ly to Providing Quality Analytrcarservices <br />