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moF M M <br /> t <br /> u - nc. <br /> 0 BEA& <br /> CHAIN OF CUSTODY REPOT MAY 13 1992 <br /> nramw <br /> Ulm <br /> Beacon Station No. Sampler(Print Name) _ DateForm No. <br /> O y u r H n S c4 ANALYSES _ LD- 2. of <br /> Project No. Sampler(Signature) <br /> N <br /> U1T05 . A <br /> Project Location Affiliation <br /> A M V ' qua S�� o <br /> e D S Stn r aC.. 'k x �� <br /> LUX T <br /> 0. <br /> Sample NoJidentication Date Time Lab No. m h <br /> fiz° REMARKS <br /> M W` j - Lf 4-16-9L 700 x I H <br /> M -t - 9 730 �� 1 <br /> w, I - )_3 IV60 k � 1 <br /> rLta -� 1 <br /> nn w,L� ► Lj x <br /> M w-z-1 4-,)o X X 1 <br /> Relinquished by: (Signature/Affiliation) Date Time Receby: Signature/Aff'iaC n� D to Time <br /> Re gamed b - (Signature/Affliation) D to Time R eived : ( ig aturel ffiliation) Date Time <br /> Relinquis b : (Signature/Affiiiati n) Date Time Receiv by:(S'gn=Nation) Dat Time <br /> Report To: q � Sill to: ULTRAMAR INC. <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> Attention: <br /> 3z.°°°" ° <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy <br />