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A L WESTERN LABORATORIESs INC. <br /> e� 1311 Woodland Ave. #1 • Modesto, California 9535' Phone 209-529-40EC <br /> CHAIN OF CUSTODY <br /> Client � �f�}T', 0 S,i.f Li_AJ4 _ Phone i,, j•�C1 s <br /> Address r� 0g, 2�2, -- CC to: <br /> J <br /> Zip yj <br /> Signature of person authorizing work <br /> under terms stated below' <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 /> I <br /> PROJECT ID �_.. No. ANALYSIS <br /> � ] / <br /> of q <br /> SAMPLED BY: (sigh e): a6n- <br /> r".:b:.; �,',t % n ers REMARKS <br /> sample• / `'j <br /> type <br /> Date Time Sample Location p`4 <br /> � <br /> G+?E Cam6. <br /> fr1 i k <br /> ! r <br /> Resin ' ied by(si ): Time Received by(signature): Date Time <br /> 04)P <br /> Relinquished byr(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 />