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A& L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> 1J <br /> CHAIN OF CUSTODY <br /> Client LHG-�iN`� � )AIJ 6f Z.7-1&4 Phone �''fJ � �5' G'? <br /> Address e• J>'. G ��y _ CC to: <br /> ��!,/ rZ L C.)L/! Zip <br /> Signature of person authorizing work <br /> under terms stated below' r °��^ 'r"� £✓ E=ar-� <br /> 'Net 30 days. All accounts past due will be subject to interest char es of 1.5% per month. <br /> 'Hazardous materials are theproperty 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 ID J n No ANALYSIS <br /> ©fV' L/'l w,,,- :_.l� of <br /> SAMPLED 81//V. (signattr e): lain �^v <br /> ers S4 f <br /> .r"".K..�'�✓( �iP,..�i.0?it={ �4 REMARKS <br /> sample <br /> type .Sample Location <br /> Date Time cae co�o. <br /> r2.f /1uf y: <br /> '`�7oD E. MA2/PO SAI le/. wrsr , ^er/,o <br /> �- y. (fy Time <br /> Relinq ed by( jlj�6_ture): [gat Time Receivedb (signature): Date <br /> f zL <br /> Relinquished by(signature): Date Time RQceived 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 />