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'`+"'if°f a^.�t�:i$t'aw�t�"�'.:;� '�!•m„"o>frs R .�''4x,.=�-.M+'',+�7' 0 4..f"4 �.a::>v� r,�i° �"��}y -r.r�= tie '+°y y+n,-,.r � -�;�, <br /> A"& L WESTERN LABORATORIES, INC. <br /> AtL 1311 Woodland Ave. #.1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client Phone U3 <br /> Address / CG to: <br /> l� ZipS-3l?lr <br /> Signature of person authorizing work <br /> under terms stated below' <br /> Net 34 days. All accounts past due will be subject to interest cha es 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 IDArt/ No ANALYSIS <br /> L� �F�rS <br /> of <br /> Con <br /> SAMPLED B , (signat' tain- 4! <br /> REMARKS <br /> sample f 31 <br /> type Sample Location �] <br /> Date Time c,ab come <br /> ff3 I50 �"� 3u�k2� GFA�NF� LD �i <br /> Pl <br /> 0,30 K <br /> • I <br /> Relin is ed by(s e): D tel Ti e Re ived by(sign ture): Date Time <br /> ok <br /> �4 960 <br /> Relinquished by(signature): Date Time . f�&eived,by(signature):. Date Time <br /> Relinquished.by,(signature) Date Time Received by.(signature)1 Date Time <br /> Relinguistied by(signature) Date . Time° Received by(signature):. Date Time. I <br /> Relinquished by(S gnature) Date Time Received by(signature): Date Time <br /> Il <br /> I <br /> Site Time! Driving Time: <br /> Start: Finish:. Total Hours. Start: Finish: Total Hours:. <br /> Dedicated`ExcYusively io Providfng..Quality Analytical,Services' ! <br />