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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�E S/yEY r,/"l iS 777-11VL Phone <br /> Address 2- 0 - ( Q x 372 <br /> CC to: <br /> /IZLUL{ eft zip 3.,/ <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest charges 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 /> PROJECT ID ANALYSIS <br /> IJ, Lc �41hSof <br /> Con. <br /> SAMP D eY: ature): tain. W <br /> ers �V� REMARKS <br /> sample <br /> Date Time type Sample Location <br /> . cw °. <br /> a 13 u �� 7 AS7E/Ld F16/ Hr, X SAPS °;� FRv .� �N sire <br /> 1�On>ESl"ic N/EG� <br /> 1 <br /> Ref fished (s' nature): pati� Time Rec ive,dby,(signature): ,Dat Time <br /> .� //7 / �y yr f\�P� 12 <br /> Relinquished <br /> (vlU <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 />