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ultrat r Inc. q,5q 1�7 <br /> hou CHAIN OF CUSTODY REPORT BEA ON <br /> lfbmnnar <br /> Beacon Station No. Sampler(Print Named -\r�_ ,�,�' at Form No. <br /> 50 2— N �o i 'I "Au k _ ANALYSES l of <br /> Project No. Samp re ; c_ . 4 ` <br /> C� i ,4. �- <br /> C ,� 12 <br /> I c <br /> Project Location A '' ion �, <br /> Aegis Environmental o o Please use Tri-Regional <br /> v detection limits! <br /> �v��i C�. x �� o <br /> Sam le NoAdentification Date Time Lab No. m � � z REMARKS <br /> s <br /> Relinquished by:(Sig \ure Affiliation) DI Time Received.by:(Signature/Affiliation) Date Time <br /> cAl <br /> Relinquished by:(Signature/Affiliation) Date Time eceived by: nature* ration) to Time <br /> Relinquished y: (Sign re/Affiliation) Date Time( R� eived byr( ture/Affiliation) a Time <br /> L <br /> V <br /> Report To: �`�tl.) 73,1 -211 f. Bill to: ULTRAMAR INC. <br /> Sheila Richgels r• 525 West Third Street <br /> Aegis Environmental rix Hanford, CA 93230 <br /> 1050 Melody Lane, Ste 160 Attention: kNL 7N � �nit=-�i <br /> Rpseville. CA 95678 <br /> WHITE: urn to Cfent Report YELLOW: Laborat Copy PINK: Originator Copy s '�°°°"�° <br /> w <br />