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M M M M M M I = = = = M iiiiiiiiiim4r i=iiiii <br /> Ultramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT ! C <br /> I <br /> Beacon Station No. Sa ler(P Name) at Form No <br /> �1 1 11 ANALY ES /� of I <br /> C4`T f &ez <br /> Protect No er(S lure) <br /> 1641. /3 2 �� � <br /> Project Location dr n0 16-0 <br /> 1, i <br /> ✓r , j— --]X a <br /> UU <br /> Sam le NoAdeMification Date Time Lab No ~ o_ z°I REMARKS <br /> l S -7,0 — Ve 7 . ZS c3 <br /> / s — ?S l�1 71. 30 <br /> � <br /> S- 30 ' VE7 7! 35 -Oz- <br /> E-3 5 Va' <br /> -OzE -35 -- Va' 7,1 ito r <br /> 5 -40 VC-7 7' 4�S -- 03 X ! <br /> S -4S - VE 7!4f oxwl I <br /> 5 -5v - U6-7 7. 5-C TAY X I I <br /> s'-,55 — VL% � 7,.5 -- c�- X l <br /> nReli ssh y (Signal Affd�at:on) Date Time Bedewed by (Signature/Aftdiation) Date Time <br /> elinq hed b (S nature/Affiliation) to Timd Received byr ignalure/Affdationy Time <br /> Relinquished by (Signature/AffrI tion) Date Time Red ved by (Signature/Affiliation) Date Time <br /> IL� <br /> , <br /> r <br /> Report To /' �L� Bill t ULTRAMAP INC <br /> 525 West Third Street <br /> Hanford, CA 93230 ,J <br /> 9(b " P39-- z/7Z 4 Attention .--_ <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy <br />