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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client r� A!,C !/ Z1D,V-5'1,11 2S/A— �� Phone j� r <br /> Address D � 3Z9 CC to: <br /> (�A zip <br /> 1191 <br /> Signature of person authorizing work <br /> under terms stated below' <br /> 'Net 30 days. All accounts past due will be subject to interest arges 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 ANALYSIS <br /> Q /y� No. <br /> ( JZ 5111-n J!' l / '/fes of <br /> Con- <br /> SAMP BY: (sl re): tain- <br /> ers <br /> REMARKS <br /> sa p e <br /> type Sample Location <br /> Date Time Grab comp. <br /> 1117 <br /> ?Ise,V / <br /> X 7- <br /> J- <br /> Relin is ed by Vgne): Date Time Received by(signature): Date Time <br /> 3 <br /> ZV1 10 <br /> Relinquished by signature): Date Time RecJived by(signatureO: 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 Analytical Services <br />