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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 �(-���? ( � i.�Q (SI��II �I N� <br /> Phone <br /> Address n . I6n Y <br /> CC to: <br /> I LR ) 1Lk� P zip �J l <br /> n. <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interes't/c7harge�s of 1.50/6 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 /> of <br /> Con- � <br /> SAMPLED BY: si flature): lain <br /> - <br /> ers �a REMARKS <br /> sample <br /> type Sample Location <br /> Date Time arab carp. <br /> Relin l hedby(sjgtla}ure): Date. Time Recewec,by(signature) Date Time <br /> -L -/71 ( !� <br /> Relinquished signature): Date Time Received gy(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 />