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>r' <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 a Modesto, California 95351 • Phone 209-529.4080 <br /> CHAIN OF CUSTODY <br /> Client (r NFSAI F V ( 7/J S/(lLT/n /o Phone <br /> Address P-O e,/J.Y -3 %q 9 CC to: <br /> l/l Zip <br /> Signature of person authorizing work <br /> under terms stated below' ' .�- <br /> 'Net 30 days. All accounts past due will be subject to interest arges 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 No. ANX//Xff <br /> < ONE ofCom <br /> SAMPLED B ' (signal e: tameef9REMARKS <br /> sample type Sample Location <br /> Date Time a.n cavn. <br /> ° 1 Y c Wt cc AT xVE DA e,(Al P- <br /> c <br /> - <br /> cG <br /> ui 7 x EI< AT 4 x <br /> el 1 1318I y 79¢/6A7-iaA/ <br /> Reb is ed by(si ): Gate Time Received by(signature): Date Time <br /> °zf3 y 155 ;+. <br /> Relinquished (signs ure): 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 />