Laserfiche WebLink
W i <br /> L WESTERM WESTLASEbkATORMS, INC. <br /> 13.1.,1 ,Woodland Ave. #1 ® Modesto, California 95351 e Phone 209-529-4080 <br /> A <br /> . . . . . CHAIN OF CUSTODY <br /> i <br /> Client <br /> Phone-., <br /> Address .I c W V- C 1 cc to' L4t,el5 a1� <br /> o ci4 F S /!� C� zip 0 ✓ <br /> F. Signature cA <br /> cf person authonzin9 work <br /> _ <br /> under terms stated below" <br /> Net 3C days. All accounts <br /> y pas due:will be subject to interest charges of 1.50/c per month. <br /> 'Hazardous materials are the proper#y of the client. The client is4esponsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastesmay be. assessed an appropriate fep. <br /> y <br /> PROJECT ID <br /> ANALYSIS <br /> i No. <br /> [ <br /> tJ of 'F <br /> Con- <br /> SAMPLED BY: (signatu(e) lain- <br /> REMARKS <br /> lo <br /> sample <br /> type Sample:Location - <br /> Date -Time „b comp. <br /> K� 0 1z.3v "lav` � � i,✓ <br /> �/- fid LIU fit/ <br /> I<: <br /> W <br /> f '�ll0 6 W1 <br /> 2-2,0 bo. <br /> L 1 ReEin v'” ed y ignature) Date. Time R c'e ved y(slgn ture):.. Date Time <br /> F <br /> OF,nC(ui ed b�{s�gnafure} f pate ]ime R eived by,(signature} Date Time <br /> Relinquished by(signature) Date <br /> Time Received by.(signature) Date Time <br /> Relinquished by(signature) Date-+ TimeRec, d.by(signature) Dale Time <br /> 4 <br /> Relinquished by(signature) Date'. Tlpne Received by(signature) Dale Tlme <br /> �r F <br /> Fio <br /> site Time: <br /> , J, Driving 7irne: <br /> 5 <br /> Start: Finish Totai Hours Start: Fimsh ``Total Hours: <br /> Water Semple Chain of:CustodyIAnalysis. App�ndEX � <br /> Derlrcafed:ExclrisrvelY_tq Providing Quality Araalyhcal 5ervrces <br />