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1♦ M = = M M M � � tftt� <br /> U mar hm BEACON <br /> CHAIN OF CUSTODY REPORT <br /> tllharer.r <br /> Beacon Station No Sa ler(Prim ) Dat Form No <br /> ALJ / ANALYSES 7 of z- <br /> HCl � ti,.(�.Gt 44 <br /> p No, ertui <br /> 1 X41 -5 _ <br /> Project Location Affil, n f , 0 , / ' <br /> GK ll <br /> S e NoAdentification Date Time Lab No a REMARKS <br /> 5-10 - 111,tJ 3 /,r�o <br /> 5-/S <br /> S3!0 - MW3 1 ; o { <br /> 5 -35--&W 3 t1 <br /> R Gnquish by:(Sig ure/Affiliahon) Date Time Received by (Signature/Affiliation) Date Time <br /> 7, <br /> Z'K <br /> Relinquish y Signature/Affillation) a Time ec=d by (Signature/Aff liahony VaIg Time <br /> Relinquished by.(Signature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> Report T Bill to ULTRAMAR INC <br /> 525 West Third Street <br /> Y Hanford, CA 93230 <br /> x <br /> 91&- 939- 217z- Attention 1,/1 <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy u 0067 9° <br />