Laserfiche WebLink
N - <br /> A & L WESTERN LABORATORIES, INC. <br /> Ell t DL 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client / 1 t U t J (L I r <br /> _ L� Phone <br /> Address ( 2 (..- V� V\(. (�.t L �..�E 1 n u� <br /> V t CC to: <br /> 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 charges of 1.5% per mo <br /> 'Hazardous materials are the property of the client. The client is responsible for pro di bsal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. �. <br /> PROJECT ID5� ANALYSIS <br /> f'e. (.r kC(,( � �� ( fit r �� o f <br /> SAMPLED.6Con <br /> 1�: ( n lure): Con- <br /> tain- <br /> ers ( REMARKS <br /> sample <br /> type Sample Location JJ <br /> Date Time Grab comp <br /> x l ? )< if X <br /> /£U1 <br /> x <br /> I til " 4 �L. - lY, <br /> Relinquishefl by(sigS41ture):/- Date Time Rede ivedby, n r ): Date Time <br /> Relinquished by(signatp Y Date Time Rece/ved y(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 Water Sample Chain of Custody/Analysis <br /> IIE <br />