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yWESTEWd LABOUATORIES,9 INC. <br /> 1311 Woodland Ave. #1 ® Modesto, California 95351 v P - <br /> o <br /> bane 209 529-•4080 <br /> F ' �? �. �P CHAIN OF CUSTODY r <br /> r1 1 <br /> Client <br /> Phone <br /> Address i V L+ GC to: <br /> � - Zip <br /> Signature of person authorizing work <br /> under terms stated below' <br /> f Ne# 30 days All accounts past due will be subject to interest charges of 7.5% 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 /> Psi <br /> PROJECT ID ,; i.. % No ANALYSIS <br /> '•f j %� .. of <br /> Con. <br /> SAMPLED BY: (signature): tain- <br /> REMARKS <br /> ATme <br /> typeSample Location <br /> r_' <br /> 1 <br /> F, <br /> 1 <br /> I <br /> ' ReIi uishedb signature:)D y{ g 1 Date Time Received by,(sign4ture): Date Time <br /> # ,Reli q/iished by(signature): Date Time Received b s' nature <br /> Y.( 9 ) Date / Time <br /> Relinquished by(signature): Date Time Received b (signature): <br /> k yDate Time <br /> Relinquished by(signature): Date Time Received by(signature): bate Time <br /> Relinquished by(sigralure); Date Time Received by(signature): <br /> Date Time <br /> Site Time: Driving Time: <br /> -; Stat Fir ish: Total Hours: Start: Finish: Total Hours: <br /> Water Sample Chain of Custody 1 Analysis Appendix <br /> F, Dedicated Exclusively to Providing Quality Analytical Services <br />