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' A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, Califomia 95351 • Phone 209-529-4080 <br /> uGUMMu fiMpW[Mu iuWsnw <br /> CHAIN OF CUSTODY <br /> Client <br /> Phone ' <br /> Address CC to: <br /> %x^ zip <br /> Signature of person authorizing work ! ta5,,y <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 <br /> i' <br /> I '1 / of h`. <br /> SAMPLED BY: fsiaAature): <br /> Co - <br /> SAMPLED A <br /> ers a <br /> REMARKS <br /> sample��/ <br /> type <br /> Date Time c,ab Como. Sample Location <br /> G <br /> f`F: / <br /> 'LL;'/3 ! I' <br /> Reli ulshed by(signature): Date Time Received by(signature): Date" Time <br /> / ✓ ' , `� <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 /> Relinquished by(signature): Date Time Received by(signature): <br /> 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 />