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A-& L WESTON LABONATOPIES, INC. <br /> 131'i Woodland Ave. #1 • ModesCo, California 95351 • Phone 209-529-4080 <br /> i <br /> K.nCu.N4.4rm4d+.riM14'•WSr4u4 <br /> CHAIN OF CUSTODY. <br /> Client <br /> /�� t.. C�/►��a �r!h/ Phone d <br /> CC to: <br /> Address _ <br /> /! L UC t� l'Lt _Zip �3 .70f,. <br /> Signature of person authorizing wrork 6 <br /> under terms stated Below <br /> *Net 30 days. All accounts pastadue'Vvlhl be subject to interest ch rg sot 1.5% per month. <br /> *Hazardous materials are the prdoerty'04 ahe c)ient. The client is responsible for proper disposal of hazardous wastes Clients not <br /> picking up hazardous wastes may%be,asseSsed an appropriate.fee. <br /> PROJECTr4 <br /> .4D ,f e� . '':�, N' ANAVSISo. <br /> e /t CJS of <br /> SAMPL D BY: ( ture); ter <br /> s`,• ' REMARKS <br /> sample a 4 <br /> type Sample Location <br /> Date Time <br /> Graf GomO- <br /> r f3ly NEC 2 Rai 2 <br /> G <br /> 5 / I D� }( N � A RCS L FrzUn�t 2 hl. <br /> `' }f2CL , Q,iii 0 -.1- <br /> lip <br /> rl7D J�• C 4 ti � <br /> •:r <br /> - <br /> rre Viiia 'c <br /> Reii shed b ure): D t Time c ive by(sig . .ture) '� ?; to Ti e <br /> sed <br /> &0o.. <br /> 4. ' <br /> by(signature): Date Time eived by(signature) + Date Time <br /> Relinquished <br /> k r <br /> 1 a <br /> Relinquished by(signature): l Date Time .deceived by(signature): , Date Time <br /> Relinquished by(signature): Date Time Af ceived by(signature): Date Time <br /> r <br /> r <br /> Relinquished by(signature): Date Time deceived by(signature)`. Date Time <br /> Site Time: O.riving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />