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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-4080 <br /> dinnWrTr <br /> p CHAIN OF CUSTODY <br /> Client Ali�i�tib ( 2A15t/L Phone A 2 <br /> Address - 0 • f>d k, � 7 74 CC to: <br /> —r—c112 LOCI! L4 zipqSF6 � <br /> Signature of person authorizing work ,r(i_ <br /> under terms stated below' /' . <br /> 'Net 30 days. All accounts past due will be subject to interescharges 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 Na ANALYSIS <br /> of <br /> Con- <br /> SAM D BY: ( ' ture): tain. <br /> ers REMARKS <br /> sa pe <br /> type Sample Location <br /> Date Timej... cw�o. <br /> Reli qui hed by( i lure): D t Time Received by(signatur : Date Time <br /> `4- 7 //Sf "V ko —qy+ 1151, <br /> Relinquished b 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 />