Laserfiche WebLink
A & L WESTERN LABORATORIES, INC. <br /> • ' 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-4080 <br /> Tr <br /> CHAIN OF CUSTODY <br /> Client l4Nhr l e ✓ C(916 uG�iNgj Phone <br /> I? <br /> >; z- <br /> Address f • a . -,-/X �7qA CC to: <br /> 2 Lzip 5 3 2 <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest c arges 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 /> PROJECTID No. ANALYSIS <br /> (fEr2 vkFr <br /> Con- <br /> SAM ED BY: ature): gain- <br /> ers <br /> ry �/ REMARKS <br /> sample I <br /> type Sample Location t <br /> Date Time Gran tomo. <br /> (t oar, x , n f fIx <br /> it x u/t77 l <br /> Mf )5to x - 1 x y <br /> S- r I x <br /> 09 -2-s1:fl I X 1 x <br /> Relinq i ed by(sre): ate Time R ceived by(signature): gate Time <br /> ti � en � -- V\-Z� I 110 <br /> Ret nq ished by signature): D6te 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 />