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,f;'.lb:' �, ^°T7Y^^�'.h. ,.,.. ...•:�, :.y - :;.k. }�„ tri.yy ,..-",,.�.,.v,;p-3n... . _. - - .. _ _ . ,.. ._ ._. _ -.. .. -... .. - .. - . <br /> A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-5294080 <br /> CHAIN OF CUSTODY <br /> Client._1�r/�� /fly Y ( z91V i Ia-Z 7-IAJ Phone ZZ q' ,�U� <br /> Address PO X /�� ` 7�..r� CC to: <br /> --rG//2ZCie-/L 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 c areas 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 IDNo ANALYSIS <br /> o <br /> cn- <br /> SAMPLE Y: (sig ): tars <br /> 0 REMARKS <br /> samlliX <br /> type Sa !e Location v <br /> Date Time Qra, Caro. <br /> /73v u So;/ SA M Pt _ D P/,e c7-� <br /> 7/1 l7 z FT 7 X x 50/1 .SArYIFan?— <br /> S� GOYt! <br /> X 2 F 7- SO/L Air!?L.6 2 ff-F r" <br /> P�LOn/ RA/N IZ06- -1- <br /> T C'AP��LI{ � �ITinlFj[< <br /> II Ei <br /> i <br /> I f <br /> Relinqs ed by(sig D to Time Rec d by signatury): at Time <br /> R linquished by(%1gnature): Date Time Rec ed 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 /> 4 <br /> Site Time: Driving Time: <br /> Start: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality.Analytical Services <br /> l <br /> J <br />