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L WESTERN LCA TORIES, - laic <br /> k 5 : 1311 Woudland'Ave,.#1 0 Modesto, California 95351' s Phone 209-529-4080 <br /> CHAIN OF-CUSTODY <br /> s1 r <br /> Client <br /> Phone 7 �J <br /> Address `[b Zi F, {�f <br /> CC to: _ <br /> Zip _ O <br /> Signature of person authorizing work t <br /> under terms stated be —' <br /> ''het 30 days. All accounts p t_ ue ill b bject t tele charges of i.5% per month, <br /> 'Hazardous materials are the property of the client. The client is responsible for proper disposal of hazardous wastes. Clients no; <br /> Picking up hazardous was may be assessed an appropriate fee, <br /> PROJECT ID ANALYSIS <br /> or <br /> SAMPLED Batur �� � tan- <br /> ` els <br /> �.L ' REMARKS <br /> sample <br /> Dale Time <br /> type Sample Locatlon <br /> pF Giab Comp. <br /> .0 <br /> 4�1-1 <br /> SZ-/ <br /> L L <br /> ,e' S2-3 <br /> v <br /> --3 <br /> r, I <br /> Relinquis by(signatur ;, ,-• D e Time Received by(signature): Date Time <br /> Relinquished by( ature): Date Time Received b (signature): i <br /> Y Da;c T isle <br /> FkP,elinquishedby(signature): Date Time a Received by(signature): Date Ti e ! <br /> FF! <br /> Relinquished by(signature): Date Time Received by(Signature}: Date Date Time <br /> Relinquished by(signature); <br /> Date Time Received by(signature): <br /> Date Time <br /> FSite Time: :• <br /> Driving Time: <br /> StartFinish: Total Hours: Start: Finish: Total Hours: —� <br /> F I <br /> Dedicated Exclusively to Providing Quality Analvfical Services I <br /> Soil Sample Chain of Custody /Analysis l <br /> ! Jf - - ._ . <br />