Laserfiche WebLink
Ultramar Inc. BEACON " <br /> CHAIN OF CUSTODY REPORT ! <br /> hiftimpar <br /> Beacon Station No. Sampler(Print Name);, Date Form No. <br /> ANALYSES / d•9 of / <br /> 6915 <br /> Project No. Sampler(Signature) 7 ; <br /> < Project Location L�� ,.o, Affiliation <br /> = 2 O <br /> Sample NoAdentitication Date Time f:at3 N m ►�— a. z REMARKS <br /> W <br /> 705 <br /> >h w 3 7-za ;. <br /> s,3 a; . <br /> .. .. •;., .�,.�., T rix '.�, <br /> Relinquished by:(Signature/Affiliation) Date Time Received by:(Sighat f(ili Ion) DateTime <br /> { <br /> Relinquished by: (SignaturelAffiliation) Date . Time.. Received by;( �gnature/Aftiliat tiny ate Time <br /> Relinquished by: ig •t ffiliation) . Date Time Received by:-(Signatdre/Affiliation <br /> ) Date Time <br /> Report To: Bill to; 11LTRAMAR INC. <br /> X -+-� She % 9 �Q'i��9 ;525 West Third Street <br /> �. . � ���..:.'� '77 : w Hanford,CA 93 3o <br /> . (916 .. . <br /> s Attention: "1J1'UP ._lg <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK:Originator Copy � �"" <br />