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11_ 11�dirtt� 1� I_ tittiiiii� 11111 1� tllittlit� (_ t�' / tlitttlii■ I_ I_ <br /> Ultramar Inc. L / ' I <br /> ��� <br /> ,�J <br /> CHAIN OF CUSTODY REPORT A- -r -7 BEACON <br /> uma�n�r <br /> Beaoon Station No :7� <br /> (Pant N e) Date Form No <br /> bl(/ r ANALYSES 9 Zot 7-- <br /> Project No 13 Sa pier(S afore} / <br /> Project Location ffrl n <br /> / `� c ! <br /> • �� 7yr .!�!?G- X vi a ,� <br /> W � = o <br /> Sample Noildentiffcation Date Time Lab No Co � z° REMARKS <br /> S` /z' z_ `"tai I III/,,?/C/ <br /> S c� <br /> 003 <br /> -s 5.5 m <br /> -5--&o t 7- [ <br /> lel lo3 �_ 1G� r� 1 <br /> S- C9)3 -13 ; 2-S <br /> R ling by (Sign re/Affiliation Date Time Received by (Signature/Affiliation) Date Time <br /> � r <br /> c <br /> Rebliquis (Signature/Afhliation) a Tim9F Received b ignature/A ili ion) a Time <br /> Relinquished by (Signature/Affiliation) Date Timee:i by (Signtur /Affiliation) Date Time <br /> Report To V gill t ULTRAMAR INC <br /> 6a 525 West Third Street <br /> Hanford,CA 93230 <br /> Attention • <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy � � <br />