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� r I <br /> A & L WESTERN LABORATORIES, INC. <br /> M 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> ClientL��luri� Phone " 1 � ; <br /> Address ' r✓ 13 fC 3 714 CC to: <br /> Signature of person authorizing work_& w <br /> F• under terms stated below* i <br /> *Net 30 days. All accounts past due will be subject to Interest charges of 1.5% per month. <br /> *Hazardous materials.are .ihe property of the client�Tge.cllent,,is responsible.for,proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed awappr'opriate fee. <br /> �y <br /> PROJECT ID No ANALYSIS <br /> of <br /> Con• <br /> SAM ED 131Y: i aturt;): tain- <br /> ers REMARKS <br /> ample <br /> type Sample Location \� <br /> Date Im comp. <br /> t �( D /=7 i <br /> ,S X V F7_ <br /> rL/S 33 , <br /> Relin d by(sig r /D e Time Reced y(sign ture): Date Time <br /> Relinquished by( Ignature): Date Time Rec ived by(signature): ate Time <br /> s <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: Finist): Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services / <br />