Laserfiche WebLink
iG�V w UP*ar Inc. <br /> C 4 i5) '3(v4- 9CHAIN OF CUSTODY REPORT <br /> Beaoon Station No Sampler(Print Name) Date Font No. <br /> 109:5 ANALYSES —l°( 9 of <br /> _ € <br /> Project No Sampler(S <br /> r qZ- 7,33 <br /> w Project Location Affiliation <br /> CA. Rj%1!5 6011 R-OMM&EAl TA L <br /> ,} 16. <br /> Sample NoAdentiticatron Date Time Lab No REMARKS <br /> r r i• '1UlJ a � — <br />� w <br /> a i s 1 <br /> rA to - 27 I 17 <br /> 1 <br /> Ir <br /> fw <br /> rtry <br /> �1 L wr� it i <br /> tr�xK 4i'"' S <br /> deli u�sh b (Signa u elAff'iliation) ate Time Race ed y ( nature/Affiliation) D r r <br /> - Irl <br /> Ell zd <br /> � <br /> J Relmuished by (Signature/AT[iation) �7 Date Time ecerved by ( nature/ iat�on) D 8� 3 <br /> w <br /> tYY J7�.ry <br /> , ` �linqusshedby (Srjnatur /Af�iliauon) �x; Date Tim Recel�ed �� inature�[A�tdiation) <br /> �yy r <br /> 5-$Mt i� s °`(h`fir`+ 5 r <br /> JfC t r r ks 7 f % s �k 1 41r 1 <br /> r-r titin +` <br /> ori a rt To Bill to ULTRA ( C ka <br /> ..� "� IR <br /> 7 !� 5251I�lesttll Street " = ,`� M.r <br /> ,9 <br /> ` r �?'br wl�y J 1. �vD F Y Hanford,dA$1?30 _ K <br /> 1ZAst V gut R5�78 X79. Attention. <br /> � . <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy <br />