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f■i tib ti• i i � _ i i i i i Il♦ i i fl• i i i <br /> unramar Inc. ' <br /> BEACON <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No. Sampler(Print Name) Date Form No. <br /> ANALYSES of <br /> Project No. Sampler(Signature) <br /> 96>102 -07 <br /> Project Location ffiliation o N 0 0 c° <br /> c <br /> o <br /> n ification Date Time Lab No. m � z <br /> Sample No./Idet REMARKS <br /> as��. <br /> Re lin uished (Si ature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> 4 ,f. qi � f 7 <br /> Re nquished by:(Signature/Affiliation) Date Time R_ecei L�by�(Signature/Affiliation) Date Time <br /> Cc <br /> �1( <br /> Relinquished by: ( ignature/Affiliation) D to Time Rece' by:( ' nature/Affi' n) at Time <br /> '�� � <br /> Report To: Bill to: LILTR AR INC. <br /> 525 est Third Street <br /> r` Hanford, CA 93230 <br /> h S <br /> Attention-­­­- <br /> WHITE: <br /> ttention:— -WHITE: Return to Client with ReportYELLOW: Laboratory Copy PINK: Originator Copy 3280031,90 <br />