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ultraVar Inc. <br /> BEARPON � <br /> CHAIN OF CUSTODY REPORT <br /> urrramar <br /> Beacon Station No. Sampler(Print Name) Dale Itfill No 2- <br /> ANALYSES <br /> ANALYSES _2s= 0I <br /> 50 Z <br /> Project No. Sampler (Signal re) ^' <br /> A/o 7-E 0 I lq6--- <br /> Project Location If'' lion <br /> N o <br /> 17E1_7'39 E�3✓��b.t��y7E�U7 t1L cs��a <br /> Lobi — -- >i =- o <br /> Samc�te No./ldentitication Date Time Lab No. —� � i � -z nEMAHKS-_�_-_-_.___ <br /> 2 3;/6 <br /> Is' <br /> Tz- <br /> /y --- <br /> r <br /> SPI-1 — <br /> C'[)Ir�fOS/T�.. EACH <br /> Lam— K X -- x - <br /> 5P_ T�12J 5P _ - - �2ouP /A/ <br /> - 6W _....- ---._.... .-.. Dale Time <br /> Relinquished by: (Signatu(e/Affiliation) Data Time Receive i n lrrrlAi ili i - - <br /> 9 /S,30 <br /> eli uist b (Si at re/ Ili i lie Date Time Rece t . ( ignatt re lAt i iatl n) A Date Time <br /> - D��le Time <br /> I�r t u sl a ure�ili OatTime R eived b : (Sign on) <br /> DL <br /> - _D; <br /> Report To: 21ci� G,,�Aur &E.e l L Bili to: UI..TRAMAH INC. <br /> 525 West Third Street <br /> (9/6) 638-209B. I lanlord, CA 93230 <br /> Attention:__k�EnlnlE. �-__F�•en}E <br /> ___ 3a eooj,.yo <br /> WI-IITf : Reltirn to Client with Reprnt Y! l I_nW: I-ahoralc ry Copy PINI: Orirtinator Cony <br />