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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave..91 * Modesto, California 95351 • Phone 209-529-4080 <br /> ,f. ,.w <br /> CHAIN. OF CUSTODY <br /> l <br /> Client # 1 £ Phone EJ l.9 o,1 4U' <br /> r <br /> Address P` 0, 3H4 4 I CC to: <br /> i <br /> QR_I..DC , CA zip 7 111 <br /> Signature of person authorizing work <br /> under terms stated below' 1. <br /> `Net 30 days. All accounts past due.wi4besubject to interest arges 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 />!, I N <br /> o <br /> Con-, <br /> SAM TED BY,( 'gnature): ens <br /> iv REMARKS. <br /> U C I "Y3 <br /> sample ;y <br /> type Sample Location <br /> Date Time cRo tomo: <br />+ <br /> ;5T? ZO " ] 1 ISOMc�c _ <br /> 1 i <br /> V-24 Si 2 hy I A I dA P1 - <br /> i <br /> I <br /> r <br /> r <br /> i <br /> E <br /> Rell u' hed b ature): Date, Time Recei db (signature): Date Time <br /> Relinquishe by(signature): Date Time ReY ived 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 /> i Relinquished by(signature): Date Time Received by(signature): Date Time <br /> i <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively.to Providing Quality<Analytical Services <br /> I , <br />