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OAF <br /> 5 � ry ;hhh <br /> A & L WESTERN LABORATORIES, INC. <br /> U 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-0.080 <br /> CHAIN OF CUSTODY <br /> Client <br /> E A RC0 Phone' <br /> i <br /> Address ' '` 7 4 CC to: <br /> -TZ( :Z Lb c r! zip <br /> Signature of person authorizing work <br /> under terms stated below' <br /> I <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 tmazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. " <br /> PROJECT IDNo ANALYSIS `1 <br /> T <br /> Al J <br /> of <br /> r . <br /> SAMPLED BY: (signature): teis i <br /> � • � � 4� eS REMARKS <br /> sample <br /> type Sample Location h h <br /> Date Time <br /> Grab Comp. <br /> t%f.' , 127d )e X <br /> T <br /> 1' 1400 x f•Al])5 ' <br /> Relinpi6 shed by(st ature): Date Time Received by sig�nayture): Date Time <br /> Relinquished by(signature): Date Time Received by(si nature): Date Time <br /> Re)inquished 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 />