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s�,.�e..et,_. !^'F lvr'►'r;J°Sa+�n`- •:s:i•Ur+ '�i�Y''';, "tr,..."rox :,h 'r <br /> Y. <br /> A' & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave._#1 e Modesto, California 95351 • Phone 209-529-4080 <br /> 0 <br /> CHAIN OF CUSTODY <br /> Client1,4101V594 f /v Phone � r � 3 <br /> Address CC to: <br /> Zip <br /> Signature of person authorizing work <br /> under terms stated below' <br /> "Net 30 days. All accounts past due will be su(ett to interestc rges of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The client 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 /> CAS No. �]7� <br /> of <br /> Con <br /> SAMPL BY: (si t e): tain- !� <br /> ers y \@.� REMARKS {J{I <br /> sample SLI I <br /> type Sample Location Q <br /> Date Time arae comp. <br /> goo I x I— I.Xlx x x C OR <br /> 8 d x 41:7 j X EK1sTi,W 115A i <br /> t /2lf X K X X 15 tA1 A4ei r-1 4 <br /> S <br /> 113D I-Fl X Dc 2XI V I 9XI01614L0G,2FixF1_b IV <br /> Relin fled by i ure)` D t Time Re ive by(sig ature): Date Time <br /> r ro , <br /> Re inquished,b.y(sighature). - Date Time R eived,by(signature}; Date Time <br /> Reling6ished by{signature) Date Time. Received by(5igr ature)``._ Date Time <br /> . <br /> Relinquished by(signature) 'Date Time Received by(signature)': Date Time . 1 <br /> Relinquished,by(signature):, Date }:Time Receivedbyjsignature):' Date Time <br /> Site-Timer Drivi.ngT+me P <br /> s* a <br /> Start: Finish. Total Hours Start Finish: :Total Hours <br /> Dedica <br /> ted" • xcluslveiy-to Providing Quality Analytical`Services <br />