Laserfiche WebLink
MM <br /> llltramb r Mc. M M M M M BEA N <br /> t CHAIN OF CUSTODY REPORT <br /> "UnrE <br /> Beacon Station No. Sampler(Print Name) D to Form No. <br /> Z ll�� ��N�,�G� ANALYSES Z9 93 Jot 3 <br /> Project No. Sampler(Si alu a /I p I <br /> 4(j _ 9Z _ 813cul <br /> `� U GL✓ <br /> Project Locatiorf �y �eft < / Afliliation <br /> 351Vo, ti < otCfcI /"C. <br /> In Q TL/✓ltilo .rdVGr <br /> dellc cw � �o�rul��w�7 !"f, .4) U <br /> L W22 <br /> Sample No./Identirication Date Time Lab No. m 0. z° REMARKS <br /> 4 29 r [a 2 <br /> 5�- 1 - z.o 2q 93 1 [ 2S i I <br /> S*6' 1 - J Z5 53 115-c <br /> 40 ¢ 29 3 l 22S <br /> 1300 / <br /> 2- Lo 4 /z9 R3 1 410 t <br /> Re lin ui by: (Signature/Afliliation) to Time Received by: (Sig nature/Allillation) <br /> Dale Time <br /> /0.'�0 <br /> I <br /> Re inquished by: (Signature/Alfiftation) Date Time Recejv d by: (Signature/Afliliation) _D,ate— Time <br /> 4Repoo: <br /> d by: (Signature/Affiliation) Date Time Received by:(Signature/Affiliation) Dale Time <br /> r� C��..,1/« I Bill to: ULTRAMAR INC. <br /> 525 West Third Street <br /> 3330 v� f �� �� t c° Hanford, CA 93230 '/ <br /> Attention: 4rJ%4s&' <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK:Originator Copy 3a�a <br /> i <br />