Laserfiche WebLink
HORRT ORIES <br />A & L WESTERN LABORATORIES, INC. <br />1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529,4080 <br />CHAIN OF CUSTODY <br />Phone <br />Address_ i� 17 �' �'�� <br />_ CC to: <br />�!' « IZ l c) 1 `'//�/!� Zip q <br />Signature of person authorizing work/ /- <br />under terms stated below' n! <br />'Net 30 days. All accounts past due will be subject to interest char sof 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 _ <br />ANALYSIS <br />No. <br />of <br />Con - <br />twin- <br />ers <br />U, <br />j <br />REMARKS <br />SAA ED BY: ,(,si,g ature): <br />sample <br />type <br />Date Time Sample Location <br />Grab Comp. <br />24 <br />36-42- <br />G -4Z <br />/ <br />ReOjii qui4hed by (sig e <br />f� <br />D to <br />1? .7. <br />Jif_ <br />Time <br />Re eived <br />/�y (signature): `_ <br />Date <br />Time <br />Relinquished by' signature): <br />/ <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Relinquished by (signature): <br />Date <br />Time <br />Received by (signature): <br />Date <br />Time <br />Site Time: <br />Start: Finish: <br />Total Hours: <br />Driving Time: <br />Start: Finish: <br />Total Hours: <br />Dedicated Exclusively to Providing Quality Analytical Services <br />