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_ Ultlrasr Inco BEA ©N <br /> CHAIN OF CUSTODY REPORT <br /> �erarr�ar <br /> Beacon Station No C � Sampler(Print Name) qt n' t'y l- t lave c' . Form No <br /> ANALYSES � r 1 `� of <br /> Project No Sampl ej� <br /> �1�� 733 L <br /> Project Location r Eliatio <br /> fC�CG If��LKe4 a � E <br /> LLvI C� Aegis Environmental x My rzoo <br /> Please use Tri-Regional <br /> w = y detection limits, <br /> Sample No/identification j Date Time Lab No ~ REMARKS <br /> ot <br /> r7'l�c� <br /> In ,v - Z 7 <br /> Relinquished by rgn turelAffiliation) Qate Time Received y (Signature/ iliation) Date Time <br /> Relinquished qy (Signature/Affiliation) Date Time Peceived by (S ature/A Ii ion) Oite Time <br /> Relinquished by' ig ture/Aff t1on) Date Time R eived by (S ature/Afhhation) a Time <br /> ie I , Y <br /> rt To t:`(10 V16 Bill to ULTRAMAR INC <br /> Sheila Richgels F& 7�5 7 , )L, 525 West Third Street <br /> Aegis Environmental Hanford, CA 93230 <br /> 1050 Melody Lane, Ste 160 Attention 6iVAIrT/1 L�I�i�'lltrr�i <br /> `W Et eJ�t ith �j t YEL Laboratory C1 y PIN��— b " <br /> rnvOriginato opy!! 1 / 328°° M <br /> < `�x„ 3"1� 7r � �' �I' �l //�rl�� / <br />