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M -u �i.r ria�sa• } ➢ --r <br /> . n �aHm ik t"'<•h Fs, t N'.� N '2w.. ,a°. w r, .:ne�s'enurvrn+reart^* •+ ;,w�.a;'�:agRAF- <br /> i... <br /> A & L WESTERN LABORATORIES, INC. <br /> AtL 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> @D <br /> CHAIN OF CUSTODY <br /> ClientIV7l�c� <br /> —^r - — - �1- — Phone <br /> Address -0 /� ~ / <br /> CC to: <br /> Zip 9S3� 1 1 _ <br /> Signature of person authorizing work -- - - <br /> under terms stated below' <br /> :Net 30 days. All accounts past due will be subject to interest harges 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. ANALYSIS <br /> zalve`` 57.q rr''-` of �ld <br /> Con- <br /> SAMPLE rBY: (Sig n/t fe): tain- <br /> N ��r, e ers ��1' REMARKS <br /> sample rZ <br /> Date Time type Sample Location E " � <br /> Grab Comp: <br /> t)4W1f7-/C-' I✓4/t5 4 <br /> Re`lirr,Aished by f�ture): / / ate Tiime 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 islgnature): Date Tirne Received by(signature): Date Time <br /> Relinquished by isignature): 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 />