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Ultramar Inc. /, �9 O? a Y BEACON <br /> dunninar <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No Sampler(Print Name) Date Fofm No <br /> 4/,7 N /- ANALYSES 6-3 7 of / <br /> Protect No Sampler(Signature) <br /> Protect Location Affiliation n <br /> N c <br /> � Q <br /> Wo0 <br /> LU x <br /> Sample NoAdentification =Date Time Lab No m E CE zREMARKS <br /> I <br /> 6-jo-`7 /.L 6 <br /> Al -1 <br /> Al W-3 <br /> 14 -G 113 <br /> 113,3 <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> of nquis by (Signature/Affiliation) Date Time Received by (Signature/Affilatio ) Date Time <br /> gz:2��, 07 <br /> -dg4� A 1,U 0 /�(.7,9 <br /> Relinquished by (Signature/Affiliation) Date Timeeceived by (SignaturelA itiaiion) Date Time <br /> C� <br /> Report To ill to ULT AR INC <br /> 525 West Thirst Street <br /> Hanford, CA 93230 <br /> Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Onginator Copy 32 SMS ISO <br />