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L <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-5294080 <br /> a <br /> CHAIN OF CUSTODY <br /> � 17C� 't <br /> r— Client 'YV e <br /> 7 r -- -- Phone <br /> Address f J, > G ! h, <br /> CC to: <br /> l � <br /> 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 charges 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 ANALYSIS <br /> No <br /> of <br /> SAMPLED BY: (signature): <br /> Co . <br /> du. �b REMARKS <br /> ' sarr.ple! <br /> 1ype Sample Location <br /> Date Time <br /> 1 <br /> �lrl <br /> _ ypuished by(signature): _ DateTime f�ece'ved by,(sign lure): <br /> � Daae Time <br /> -Heli q (shed by(signature): <br /> I <br /> Date Time Receve db (signature): Date Tima <br /> Relinquished by(signature): Date Time. Received by(signature). <br /> Gate Time <br /> Relinquished by(signature): Date Time Received by(signature): - <br /> Date Time <br /> Relinquished by(signature): Date Time Received by(signature): <br /> Date Time <br /> Site Tirne: Driving Time: <br /> Start. Finish; Total Hours: Stan: <br /> Finish: Total Hours: <br /> Water Sample Chain of Custody/Analysis Appendix 9 <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />