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A '& 'L IIVEST. F N LAB RATQRIES IN'C.8 <br /> 136 1 Woadiaritl-Ave. °#1 + Mcidesto, QaIifomia."9535: "+'P.Fi"one 209-529-4080 <br /> . . <br /> RGNCULNRAI.lNIRpIMlNW M[IIIfIXlA- -- <br /> �` CHAIN OF. CUST�Oblf <br /> Clieht. /\. Z Phone <br /> 'r [a' <br /> Address. d d CC to: <br /> (L. z•ip . <br /> 1� I <br /> Signature:,of.person.:authorihi',O'work. <br /> under terrhs.stated below ' ) <br /> 'Net 30:days. All aecourits Ip Jst due3 wlII be subject to interd,st charge .of`1'%6.per month. <br /> 'Hazardous materials are`lhe.praperty_bf tne"cNent The client Is responsible for proper disposal of hazardous wastes. Glients not <br /> ,0i 'king u"p h'azareious waste;inay bd:assessed an appi'oprike fee. <br /> PROJECT ID "No AiVALYSIS � <br /> of <br /> +von,. - <br /> SA"MPL" Y (sig"n2� ure) tarn: <br /> REMARKS <br /> type Sample Lb6itl"on. D <br /> Date. Time <br /> f� <br /> ------ <br /> Al <br /> , <br /> r, <br /> Relinq hed by(s'g Vie): Date T 144' Ree eiv d by"(sigriatu }: D to Time <br /> eli q y� 9.. , , y( <br /> Relinquished b si nature: late Time. Recti ed b signature}: Date Time <br /> Relinquished;by(signature); !]ate Tune ;Re cewetl by(signature). Date Time ; <br /> q <br /> Relinquishedby.(signature) F bate Tim" 6 . `Received iby(signature): Date Time <br /> ;f <br /> Relinquished by(signat"ure), Dale Tune Aeceivedby(signature): Date Time <br /> Site Time: i .Driving Time: <br /> Start: Finish. :3� Total'I ours: ) Start: Finish Total Hburs: <br /> 00 c0ed.:Ezclusively, to ProVfdrng'QU lift' Analytical Services <br />