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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-40EC', <br /> CHAIN OF CUSTODY <br /> Phone <br /> Address. tJ y_[.C�� 7 — GG to: ....__ <br /> zip /- --- -_—.. <br /> / — <br /> Signature of person authorizing work --- <br /> under terms stated below' _ <br /> -Net 30 days. All accounts past due will be subject to interest ch es of 1.5% per month. <br /> 'Hazardous materials are the property of the client. The client i responslble for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID j No. 4ANALYSISof <br /> SAMPLEP/ Y: (sig ne): taim <br /> ers REMARKS <br /> A tyeNa. Sam le Locationj0a.teTime ,so <br /> fs „ s rrs �' / X X <br /> !br)D _62 �T r� <br /> Relin ihedby(si re): D to Time ReGejved,by(signalure): Dale Lme <br /> /I <br /> Relinquish do (signature): Date Time Re 11 1eived by(signature): Date Tune <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> I <br /> Relinquished by(signature): Date Time Received by(Signature): Dale Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> 1 <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish. Total Hows <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />