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y <br /> 1 <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> Client `N{��5��� COALJULTLt41 - - Phone 0060-14493_ <br /> Address / SOX 3 / (T CC to: <br /> 'Tu R L dGK, 1"A//,//� Zip 9s 30.1 <br /> Signature person authorizing work <br /> under terms <br /> stated below' tilf�Y4! <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 /> PROJECTID f No ANALYSIS 0 <br /> Sf �RNAzDs <br /> SAMPLE Y: is taim <br /> ers ``7� REMARKS <br /> sampl <br /> laa-o V P�\Q�\� [ /�h <br /> Date Time type Sample Location OQ' F+r (\ •{ _ <br /> orae camp. 'r <br /> �o z�D x a 1lSa W/yliN,o�sl w4YjXjVjYh< X <br /> 4rk I I l9Mfl E, 14111 a x x xx I X- -'t: <br /> Relin is ed by i re): Date, Time Received by(signature): Date Time <br /> r� lS17 <br /> Relinquished (signature): Date Time Received by(signature): Date Time <br /> . L <br /> Relinquished by(signature): Date. Time Received by(signature): DateTime <br /> Relinquished by(signature): Date Time Received by(signature): ` . ', � Date Time <br /> Relinquished.by(signature): Date Time Received by(signature): 1 Date Time <br /> Site Time: I Driving Time:. <br /> Start: Finish: Total Hours: Stan: " Finish: Total Hours: <br /> � 1 ��� J lyt.. Dedicated Exclusively to Providing Quality Analytical Services <br />