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uitrJLr inc. BEOON <br /> CHAIN OF CUSTODY REPORT <br /> unea�nar <br /> Beacon Station No. Sampler(Print Name) Dto Form No. <br /> �G ANALYSES ! wof <br /> Project No. Saeerinatu e)�+ <br /> J L <br /> CD c <br /> Project Location S a� <br /> d <br /> Wa+ z ° <br /> Sample NoAdentification Date Time Lab No. m a z° REMARKS <br /> Relinqui jby ignature/Affiliation) Date Time Received by ( at r - Date Time <br /> re i do Date Time Re v b ignaiure/ t Dale Time <br /> 141'61i ui' h by: ( na ur f iiation) Date Time Received by: n) le Time <br /> -------------- <br /> Report To: Bill to,-*' ULTRAMAR INC-. <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> Attention: 7! <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy 3280031/90 <br />