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Unr r Inc. BEA ON <br /> f CHAIN OF CUSTODY REPORT <br /> unranuw <br /> Beacon Station No. Sampler(Print Name) Da Form No. <br /> ANALYSES /� �"� of <br /> Project No. Sampler(Si nature) <br /> N <br /> Project Location CD <br /> C <br /> _ <br /> el- i� s lin!✓ rnv U <br /> x `"" o <br /> LU Z aC <br /> Sam le NoMentification Date Time Lab No. m � � z° REMARKS <br /> I {k <br /> i:. <br /> I�1 <br /> I !� <br /> I : <br /> k <br /> t . <br /> Relinq ish Y (Si�y're/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> Relinq#hed by: (Sign ure/Affiliation) Date Time Recpived.by-(Signature/Affiliation)----....-_-._--- Date Time <br /> L <br /> Relinquished by: (Signature/Affiliation) - Date Time Received by.:-(Signature/Affilialion)7 Date Time <br /> 61/ <br /> j Report To: Bil o: ULTRAMAR INC. <br /> 525 West Third Street <br /> Hanford, CA 93230 l <br /> Attention: <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Cepy X80°"90 <br />