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A & L WESTERN LABORATORIES INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> CHAIN OF CUSTODY <br /> ClientCON-7J�Lr���� Phone <br /> q <br /> Address OX / [A CC to: <br /> zip� 3 <br /> Signature of person authorizing work / ��"Yt. <br /> under terms stated below' <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,pf,hazardous wastes. Clients not <br /> picking up hazardous wastes may be assessed an appropriate fee. <br /> PROJECT ID No ANALYSIS <br /> RAWOA/ f/US Co- � <br /> SAMP D BY: ' ature): ta'n- <br /> fli� � ers Q REMARKS <br /> 7 <br /> sarm <br /> typeple I <br /> Sample Location Q <br /> Date Time Gran comp. <br /> 711,7- /07 0 X 1 4/AIMC R OA 0 <br /> z a 1035- X L i A14t QUA 15 Z X <br /> Reli ylshed b ' ature: patj Time Rgeeived by(signature): ate Time <br /> ��,::Aq � :Ale' �l4 <br /> Relinquishe by(signature): Date Time R ceived 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 />