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A & L WESTERN LABORATORIES, INC. <br /> At <br /> L <br /> 3 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529080 <br /> CHAIN OF CUSTODY <br /> Client CND�SN�Y ��NS�G T//✓(7 Phone <br /> Address / Qx CC to: <br /> -J_u g L c)C& KA zip f5--191 <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 is!responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> —� qo <br /> —oS �• <br /> PROJECT IDN o. ANALYSIS <br /> // n / o f <br /> C.- f-�` Con- <br /> S4M� D BY: at fain_ P <br /> / y( ern REMARKS <br /> sample <br /> type Sample Location <br /> Date Time Greb comp <br /> Mao X25" w 9 1 X 1 F <br /> 7 1600X ZS w 9 D mFST G e� I SG <br /> tG o x an16 ivn/ WELL 225 FT <br /> 7 17 o a X r,,i q X A LL 7,DD F <br /> Reli u hed by( re): °/��te Time Reeiv�d by �nare): D to Time <br /> Relinquished b (signature): Date Time eceived 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: <br /> Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />