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mar Inc. r`AC®N <br /> CHAIN OF CUSTODY REPORT <br /> unran w , <br /> Beacon Station No. Sampler(Print Name) D to n F rm No., <br /> --- ANALYSES 3 of s <br /> Project No. i3ampler (Signature) '� f '06 <br /> d � �d►��nkl 7t+ * <br /> co <br /> Project Location Affiliation 0 m <br /> U, c <br /> m 0 <br /> L1 C G{, e a v/ n0h'2el W <br /> Sample No./Identification Date Time Lab No. m � � z REMARKS <br /> L6)5'—� - 6 1 .3 �C 1 Soi` r <br /> �v / 7 ` '1 Sar <br /> I 7t3 8 r o � <br /> B- 2 -16 c5-/ .S 6 a:l <br /> t i ( r'J <br /> 3 31 <br /> Relinquished by: (Signature/Affiliation) Date Time Received by:(SignaturelAf iliati n) Dae Time <br /> deli.quished by: (SignaturelAffi is ion) 7 to Time Received by: (Signa( rel ffiliation)` to Time <br /> Yom. i - //c� =0< t P [�� plx %a?_D2 <br /> Relinquis ed by: (SignaturelAffi iation) Date Time Receive : (Signature/Aflmation) Date Time <br /> Report & I Bill l : ULT AMAR INC. <br /> 525 West Third Street <br /> h �l Gi Hanford, C+ 93230 <br /> Attention: ! {N 1► GT f l -_ <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy 32 "f°° <br />