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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-3080 <br /> CHAIN OF CUSTODY <br /> C, - c32 - ccI <br /> Client if l'D 1CtL tit/ Phone "o-/403 <br /> Address Q • B X 3 7 4y� cc to: <br /> -7—al,-7 4-a -& c� zip 9530/ <br /> Signature of person authorizing work <br /> under terms stated below- It <br /> 'Net 30 days. All accounts past due will be subject to interest harges 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 /> rl picking up hazardous wastes may be assessed-an appropriate fee: ----- <br /> PROJECT ID No ANALYSIS <br /> ( �24GI of <br /> Com <br /> SAMPL BY: (si re): Calm <br /> ers REMARKS <br /> •�� sample <br /> Q type Sample Location <br /> Date Time c,,,1comp. <br /> }' /SD0 15:,rZeAW11 eAofvl <br /> m <br /> f <br /> Rel in ed by(si e): D to Time Re lure): Date Time <br /> /o <br /> Relinquished by signature): ate Time Receive 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 /> Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services / <br /> r <br />