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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client C e, 1/ PAs(Z 4 Tl&r Phone 422 - 16502 <br /> Address_.o . / el) X �:1 4- q, ,J CC to: <br /> /J10,-6, (fA zip 11�Y <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 rges 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 ANALYSIS <br /> I� No. <br /> 7L C`F of <br /> Con- <br /> SAMPL, BY: (Si nature): tain <br /> ample Y� <br /> ars <br /> REMARKS <br /> s <br /> type <br /> Date Time Sample Location <br /> aro tomo. Q '` <br /> q k S-Prie X <br /> Rail u hed by( ure): 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 /> 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 />