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A & L WESTERN LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 9 Modesto, California 95351 • Phone 209-529-4080 <br /> G¢iNlN4LL,f1M¢peW£ IrvDU5r9LLL <br /> ••mma <br /> CHAIN OF CUSTODY <br /> Client ��15,��v' 0 �(<,/Il '�i-y�r1 Phone 1 " <br /> uz , .z <br /> Address r7 0 E' Y i f CC to: <br /> (.f )Z L t^( !L Zip <br /> Signature of person authorising work <br /> under terms stated below' 1t - <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 wastos may be assessed an appropriate fee. <br /> PROJEC))T�� IID No ANALYSIS <br /> of <br /> Con- <br /> SAMP"^ED BY:,(so nature): Iain- 2k <br /> ers REMARKS <br /> sample <br /> Date Time type Sample Location (�( <br /> Grab Comp. <br /> 7� d' �DEnI`7 <br /> Reli#q iished by Nbriature): i�te Time Received by.(signature): Date Time <br /> 7� <br /> Relinquished by(signature): Date Time e(�Lwed by(signature): i' Date Time <br /> I <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 />