Laserfiche WebLink
�tmar Inc. <br /> CHAIN O USTODY REPORT IMCON\ <br /> 17q-/Z <br /> t3eaoorr Station No _ Sampl (Prem Name) n Date Form No J <br /> ANALYSES of <br /> Prosect No Sampler egnature) <br /> y, q 3 1211 <br /> ProtectLocatan Affiliation <br /> (O C- <br /> L� U <br /> 0 <br /> S`am ale No/ldentificatan Date Time Lab No m z I REMARKS <br /> 0 —7V1 <br /> —A <br /> w - 0Z6 - /-,1LAj lZr3J <br /> •�r <br /> w -0 9 2 6 -✓v, <br /> -06 <br /> v,' 2 tv r-1 c/-j <br /> Relinqui by (Signature/Affile t1 n / "'1 <br /> Date Time Received by (Slgnature/Affil1a11on) Dat�T, <br /> 540 <br /> Relinquished by (Slgnature/Aiteleatlon) Date Time Received by (Signa lure/Affiliation) Date Time <br /> Relinquished by (SignaturelAffiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> '✓?�f`LII/Z4't /< , ' - Art <br /> tit I +�rrt( 44 2 Li? i y y7 <br /> Report To - <br /> Bill to ULTRAMAR INC <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy <br /> u Laos+Ao <br />