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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> 2L <br /> CHAIN OF CUSTODY <br /> Client. 5 Phone e V o Z 1 Jae <br /> AdtlressI �(�%�`7� CC to: <br /> :4412 t C4 i� (��� Z. q 62 <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interes 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 No. ANALYSIS <br /> -VA/ 'f� <br /> Con <br /> SA ED 13'Y: ature): tain. <br /> ers <br /> REMARKS <br /> Date Time <br /> e � <br /> type Sample Location <br /> c.=e conn, <br /> �J � >� � I i> ( �i G T fil <br /> Relin ed by(sigyf re): Date Time Received by(sig ,re): Date Time <br /> �� <br /> 71t,1170 .-.,� -� �4u�1'i 103 1 <br /> Relinquished by i nature): D to 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 />