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MMMMMM <br /> funra r Inc. BEA yaN <br /> ~ CHAIN OF CUSTODY REPORT <br /> utf "M <br /> Beacon Station No Sampler(Print Name) D to Form No <br /> / C/� n�/�r ANALYSES r Z ! of <br /> Project No Sampler nature) <br /> Aififiation `° <br /> Protect Location <br /> � / � � <br /> tie tt �^ 4 o/1. I-K+erO'rtt04f,17 f /11 Ir � �—p <br /> Lad, C-4 7" x o <br /> w = = 16 <br /> Sample No/identification Date Time Lab NoIr- REMARKS <br /> S�- I z - 4 2-0' <br /> (2- 6 30' o r t <br /> co <br /> S�- 12- 8 40 v r�2- 1 <br /> s6' 12 - tZ ° <br /> � 51112 - 13 6S t / ooV <br /> Relinquish d by (Signature/Affiliation) Date Time Received by (Sig ature/Affiliation) Date Time <br /> 44 J)J <br /> Si naturelAlliliation Dle Time Receiv y E natu t filial n Dater me <br /> He�lingwshed by a <br /> g � _ <br /> ire i qu b igq t 1 f is t n ate Time R i ed b (Sig ture/A fdiali Date Time <br /> 115 <br /> Por o e Bil ULTRA AR INC _ -- - ---T� <br /> del Eh�,r.ha�- l ��f°�rirwTrlnc 525 West Third Street ��E-G- ��;�1 <br /> Hanford, CA 3230 by vu: <br /> va <br /> -T33o . , < /0() Attention _ <br /> dale O C <br /> ��rl I�Tt- Ctr'h rrn in r'Ir�n� ^rfh Rr'nnrt YR t CSW t �hor�inry ( npy PINK 0nrtrnator Copy <br />