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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 e Modesto, California 95351 0 Phone 209-5294080 <br /> CHAIN OF CUSTODY <br /> 41 <br /> Client <br /> Phone <br /> Address- R <br /> CC to: <br /> ZIP <br /> Signature of person authorizing work <br /> under terms stated below' <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 /> PROJECT/ID No. ANALYSIS yq <br /> IVA- VU of 0Con- <br /> SAMPILFY:,J�sinnature): tain- <br /> ers <br /> REMARKS <br /> ample <br /> Date Time type Xample Location <br /> Grab Comp <br /> e,I I&J <br /> 4-H <br /> R,Tquished ature): TDWR Time Re,,-B,,,,,d by sln4aure Date Time <br /> )a <br /> c., <br /> /77& <br /> Relinquish t�y(signature): Date Time Rec Received by(signal re): 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): <br /> 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 />