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Jr <br /> y, A & L WESTERN <br /> LABORATORIES, INC. <br /> 1311 Woodland Ave. #1 • Modesto, California 95351 • Phone 209-529-4080 <br /> k <br /> CHAIN OF CUSTODY <br /> Client �. (.E �P./ `,�q .(�/r%i /iF� �c lltll� i/1� C'. Phone ��% ' l>l07_ <br /> Address r� G'X � <br /> CC to: <br /> t C-> �� '. zip <br /> Signature of person authorizing work <br /> under terms stated below' h 47_2�__, <br /> t <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 wastes may be assessed an appropriate fee. <br /> PROJECT ID ANALYSIS <br /> No. <br /> j of <br /> Con- <br /> SAM,;b(.ED Bignature): tain- <br /> ( ers �) REMARKS <br /> sampl <br /> ype , <br /> Date Time te Sample Location <br /> G,ab Comp. <br /> z s l 5`' X - f X <br /> 1, 11r . x 1 f <br /> FR <br /> RelirAuJished by ature): t9 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 /> [Relinquished <br /> inquished by(signature): Date Time Received by(signature): Date Time <br /> by(signature): Date Time Received by(signature): Date Time <br /> Time: Driving Time: <br /> rt: Finish: Total Hours: Start: Finish: Total Hours: <br /> Dedicated Exclusively to Providing Quality Analytical Services <br />