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P& L WESTERN LABORATORIES,OR ES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> ClientCcI�LT//1/(� Phone <br /> Address-'r-'- U x ;7 !-4 CC to: <br /> �(4g C GG_IST C zip <br /> Signature of person authorizing work , ; r. <br /> under terms stated below' <br /> 'Net 30 days.All accounts past due will be subject to interest charg/es 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 /> PROJECTID No ANALYSISof <br /> /< YI d / S Con- <br /> SAMPLED <br /> n•SAMPLED Y: (signat tain- <br /> e): ers ti� REMARKS <br /> type Sample Location <br /> Date Time Grab come. <br /> 134f x 'n l J is P7-1// <br /> S 17,1_ 2 <br /> s 12/ Ix 11( <br /> Reli w ed by( re): <br /> ,h Date Time Reodlved:by(signature): Date Time <br /> Relinquished by(signature): bate 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 />