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A & L WESTERN LABORATORIES, INC. <br /> AtL 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client CNjE�SN4y �'oNsu�r�Nr, _ Phone <br /> Address �• �c? CC to: <br /> 7-G[RLock t1A zip qS'3 <br /> Signature of person authorizing work <br /> under terms stated below' ��—���wvv��,«c <br /> 'Net 30 days. All accounts past due will be subject to interest char/s of 1.5% per month. <br /> Hazardous materials are the property of the client. The client is r sponsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PRCT ID No ANALYSIS <br /> r <br /> 5na e Tia I Y ca <br /> Y - � e7 <br /> 0 0 <br /> SAMP BY: (9 re): tars /h �9�\Q REMARKS <br /> safnple <br /> type mple Location (/ <br /> Date Time c,ab —P <br /> S /40 5-0s7 SO M,4 X <br /> shedby I ure): Pate Time Received by(signal re): r ate Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> Relinquished by(signature): Date Time Received by(signature): Date Time <br /> TRelmq,,,­hedbysignature): 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 />