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A & L WESTERN LABORATORIES, INC. <br /> [AEt jL) . 1311 Woodland Ave. #1 e Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client /V uLAM7 _ Phone 660-1401 <br /> Address CC to: <br /> �U2 L_o ck- t'A zip 7 3 <br /> �. Signature of person authorizing work <br /> under terms stated below' XV'61�4 <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 /> PR OJ CT ID NoANALYSIS <br /> C 2 LA' l - <br /> SAMPLE�V'- '`sig ) ters �l �Q•� <br /> ra" REMARKS <br /> sample <br /> t <br /> ype Sample Location Y <br /> Date Time G,ao comp <br /> -- ► FZ 5 U X <br /> t r <br /> 140 y <br /> I I 1 30 X FON1? <br /> I 15-20 V I I /lz2f A7'1OA! WIC-71-1- <br /> �Z ► /t 27N t. X <br /> Reli q fished by s ure): D t Time Rece e by(sign a ur ): Date Time <br /> r 1 03 17; <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> t <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 />