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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client dH 5 JF / CONSUcZ/A/LI Phone b' /dlJ� <br /> i <br /> Address__P_o EO)( 7 r7-4 CC to: <br /> TJ—L-oe-w , r A Zip <br /> Signature of person authorizing work . l <br /> under terms stated below' .(�L��—/�/ kl �i -vim'= <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 ID Na ANALYSIS <br /> 0� <br /> p11 <br /> of <br /> Con- <br /> - <br /> SAMP BY: (sigh lure): r�. <br /> ainREMARKS <br /> tiSL.6�-bt �j�J <br /> Ct,�--,,-c.s <br /> samme I v <br /> type Sample Location <br /> Date Tlme era, coma <br /> '' cE� onJ� t ?t SFIv✓�c �rz .� rfcrE a - <br /> /✓. C O/✓ N k l�)1 1 c F t] ,rp'1(7C;;t <br /> sd a. <br /> Reli qishedgnature). Date Time Received by(signature): Date Time <br /> Relinquished by(signatur Date Time Received by(signature): Dale 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 />