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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-0080 <br /> .tea <br /> CHAIN OF CUSTODY <br /> Client 144)g!oJg fLl Phone 40 z — l4Se2 <br /> Address f•O Ok 79,4 CC to: <br /> U(2101VI 4A zip `'SSl <br /> Signature of person authorizing work . I " <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest iarges 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 /> PROJECTID No. ANALYSIS <br /> C(� of <br /> P Con- <br /> SAMP ED BY: (si re): tain <br /> ers <br /> i 1�Pr REMARKS <br /> sam le <br /> tYOe Sample Location <br /> Date Time c„e cameo. <br /> S Q , • a x 7 4 T. / }C SAivIPcEJ F2c.r c✓<. t-C <br /> X 7 7-1? l rrr 57 . <br /> Relin h by(signs tD to Time Received by(signature) Date Time <br /> `-'f) rL- 51ti1 115v <br /> Relinquished by( 4 nature: 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 />