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A & L WESTERN LABORATORIES, INC. <br /> ALL 1311 Woodland Ave. #1 • Modesto, California 95351 • PhonO 209-5234080 <br /> CHAIN OF CUSTODY <br /> Client Chi ESNE �/ CDNsu�ri�✓/�/��/� / Phone <br /> L (7 / -14o? <br /> Address F- 0 , y© CC to: <br /> Iurz <br /> %Zip <br /> Signature of person authorizing wor <br /> under terms stated below' r/�"••/ <br /> 'Net 30 days. All accounts past due will be subject to interest charges 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 IDNo. ANALYSIS <br /> r/ A/ of ^ <br /> Con- <br /> SAMPLE Y: (signC�3uYgjz ersQ' FEW y Q <br /> y REMARKS <br /> AsD <br /> �P <br /> Sample Location 4 <br /> Date Z4ov e4Y /�ADru/l Y X fitT4R SiiTr ec.,, WAr o-wry-rlc W�c� x X X svo0, /4ADeu <br /> sf !3p✓ r lrzr�/ r/ON ECC x X SOO F, /"lA✓]CV A <br /> Reli ished by ture): D t Time Receiived b (signature): ..Date Time <br /> Relinquishe 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 /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />