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.ra y��R+^•C+r"",.;ti--+ao-- �fighRu'c. ......... _ ..,, . a ., ... .... <br /> f A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 a Modesto, California 95351 • Phone 209-529-4080 <br /> j CHAIN OF CUSTODY <br /> Client A]� GT til phone <br /> Address—,P. CC to: <br /> ` ��QLDC.II CA zip 22y—/ <br /> { i <br /> Signature of person authorizing work <br /> under terms stated below" <br /> 'Net 30 days. All accounts past due will be subject to interest c rges of 1.5% per month. <br /> *Hazardous materials are the property of the client. The client •s responsible for proper disposal of hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECTID No ANALYSIS \ <br /> �7A rn E G D I VDI /1T�IA G AIL- Cof <br /> an• 0V <br /> SAMPLED : (signa ); Win- <br /> REMARKS <br /> sample <br /> type $a a Location <br /> Date Time Grab comp. <br /> } OGfT�/ UUmESTI� WELL <br /> } <br /> Re' i hedb ure): Qat Time Rec edgy(signat,�re): D to Time <br /> Relinquishedby(signature): Date Time Re eived 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): 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 />