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10 <br /> Ultra ar Inc. BEACON r <br /> CHAIN OF CUSTODY REPORT <br /> ultran,ar <br /> Beacon Station No Sampler(Print Name) Date Form No <br /> 1 -7o— / / ANALYSES 7-7—% of <br /> Project No Sampler (Signature) CD C <br /> Project Location Affiliation <br /> SoCDco CD C <br /> x <br /> WM = o <br /> Sample No/Identification Date Time Lab No m � zo REMARKS <br /> z0 <br /> M w - zs <br /> MW — 30 <br /> M v ( - 3-5 <br /> M w <br /> M til r q.� <br /> /'4 S-0 <br /> Relinquished by (Signature/ ffilialion) Date Ime :Recet�ved by (Signature/Affihatton) Date Time <br /> - �� -71Uj (j l,6Y Ik 7/9 <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> 17/711 d z <br /> Relinquish by (Signature/Affiliation) Date Time :ec e y (Signa urelAffiliation) Date Time <br /> Report To / BT p �M V f3dl to ULTR <br /> ^ AMAR INC <br /> d / } 525 West Third Street <br /> x 3 7 S 7 d Hanford, CA 9323 <br /> Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 328003190 <br />