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I . <br /> w i L WESTERN LAS4-4ATORIES INC. <br /> AtL 1311 Woodland Ave. #1 • Modesto, Caiifamia 95351 • Phone 209-539-4080 <br /> i <br /> CHAIN OF CUSTODY <br /> 2566 <br /> Client_ Wf Lrbriv ;.00-�-f GN Phone s�I-OS 3/ _ <br /> Address--- - !303 _=�L V CC1,Vd JE Ce to:4galml : , y-/,. L <br /> IDE rTd , CA —ZIP -353517 1047 <br /> ..T" <br /> Signature of person authorizing work <br /> Say [2 25-370 <br /> under terms stated below' on 0- - <br /> 'Net 30 days.All aoaounts past due will be subject to Interest charges of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The cllont 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 /> L of .� <br /> SAMPLED BY: (aignatrjr <br /> Co - <br /> SAMPLED <br /> era / REMARKS <br /> Ole <br /> Sampla Location <br /> Date Time d„b ccrna f <br /> S�I /00,0r� V — I A X <br /> s/11 0} ✓-Z 5 <br /> 5► s.5 5' X �( <br /> Reilnqu by( nater Gale Time Recgived by(signaturey D e Time <br /> Relinquish 1)y(slnature): D to me si future):' a Time <br /> R Enquished by Si ature} Aceived by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature); Date Time <br /> Relinquished by(signature): Date Time Received by(signaturaY Date Time <br /> r <br /> 51teTime: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Ser'vfceS <br /> Sec IV, C <br />