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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209,529-0080 <br /> CHAIN OF CUSTODY J <br /> Client Z �-i r �tii♦E�� �(// -�6�� Phone 4 n <br /> Address�2_ ���V �i7 /� CC to: <br /> � r LfLCJ� n ZiD.1 9/ <br /> Signature of person authorizing work/ <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest qq argil es of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The client fs responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID No ANALYSIS <br /> Of <br /> Con- <br /> SAM ED BY: (stilt nature): gain- <br /> ers REMARKS <br /> ARKPId <br /> Time rg opo.type S mple Location <br /> Date e e <br /> 7 u <br /> Relinq s d by(sigif Date Time Received by(signature): Date Time <br /> X12. r, % ) 'I A , � i ;� <br /> Relinquished by gnature): D le Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />