Laserfiche WebLink
At r elr Nneo <br /> i = ~ , <br /> CHAIN OF CUSTODY REPORT BEACON <br /> Beacon Station No Sampler(Print Name) Date F�rm No <br /> ANALYSES �.c.u�96 of <br /> 6 93 �� � H �s� <br /> Project No Sampler(Signature) 40 <br /> 9 -661.5 -01 <br /> TAT <br /> Project Location Affiliatcri 0 <br /> H N O <br /> 4l <br /> X <br /> W22 rzo <br /> Sample Noildentification Date Time Lab No m � REMARKS <br /> A W' f 6-,L-u-16 ��- <br /> �S 61-t i <br /> W- 1 G '7 o-3 <br /> o <br /> 6 047b <br /> ` M W 61111� <br /> M W -�-q 0 <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> %�� 04-a& gn� <br /> Relinquished by (Signature/Affiliation) Date Time Receiv by (Signa e/Affiliation) Date Time <br /> ,-If, Z wE�>-r' 1730 , —� - <br /> Reli wished by (S nature/A filiation) Date rime Received by (Signature/Affiliation) Date Time <br /> Report To Bill to ULTRAMAR INC <br /> a�L/Z/ � �} Ha West Third-3 et <br /> �'^'1 Hanford, CA 93230 <br /> Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 52800"'90 <br />