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n <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209- <br /> ' 529-4080 <br /> CHAIN OF CUSTODY 2634 <br /> i <br /> I <br /> Client_. v►`5 f L�P.� �� Sf C� <br /> � r / Phone <br /> Address_: f�" J !.~r! �" f>i�'(s r <br /> i � CC to: _rs5 � :"=k-70N vJA <br /> ra <br /> Zip v <br /> Signature of person authorizing work <br /> under terms stated below" <br /> 4 :r L <br /> 'Net 30 days. All accounts past due will b� subject to interest charges of 1.5% per month. <br /> it '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 IQ �A� '� ANALYSIS <br /> t No. <br /> C' V/;,/- 0 j< of <br /> SAMPLEQ BY: (siqlaaureCon- <br /> p_ -4_, tain- Q� <br /> 1 <br /> ers REMARKS <br /> sample 3 <br /> Date Time type Sample Location <br /> Grab Comp. <br /> LI/11 lL15 �( 1 V uti— s s <br /> G r•"] R? f Z�� � 1�l L,1'� r <br /> l <br /> L-t 11>: X f W <br /> t <br /> I <br /> 1' <br /> Relinq�ti ht by na a}..f <br /> MY Time Received, y(signature): Date Time <br /> \\ �> b/L'� <br /> Relinquished by(si nature): Date Time Rcrceived 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 /> I <br /> Relinquished by(signature): Date Time Received by(signature): Dale Time j <br /> Site Time: Driving Time: i <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> t <br /> Dedicated Exclusively to'Providing Quality Analytical Services <br /> � ,� Sec III, C2 <br />