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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 AIy (7- A/fC/C 1/^/6 Phone J62 2 <br /> Address d ou 379 CC to: <br /> —ra 17 4-0 K-k /'A zip`1 <br /> i <br /> Signature of person authorizing work �; <br /> under terms stated below' 4r, <br /> 'Net 30 days. All accounts past due will be subject to interests 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 /> �• <br /> IV E, S>JlJr� Con- <br /> SAMMMM�ED BY. nature): Iain- Mrs <br /> J / , ers REMARKS <br /> sample <br /> lype Sample Location <br /> Date Time GraO comp- <br /> 3 3rI <br /> Relingohed by(si e): gate Time Received by(si nature): Date Time <br /> Relinquished by(signature): / Date Time Received by(signatut` 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): TDate Time <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />