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Ultratar Inc. <br /> i <br /> oumrwnwCHAIN OF CUSTODY REPORT BEAC®N <br /> Beacon Station No Sampler(Print Name) Date f=orm No <br /> �/ 6 or y 1-?e? let_ ANALYSES t 2 - .2- of (a <br /> Project No Sampler( ignature) <br /> Project Location Affihation o <br /> N N O <br /> c X <br /> w = = <br /> Sample NoAdentification Date Time Lab No m a rzo I REMARKS <br /> CA Ll-- at5 <br /> s <br /> l Ga <br /> efM_ s <br /> I <br /> Reli wished b (Signature) ifdiation) Date Trme Received (Si ature/A tfo Date Time <br /> )-VL W/1 <br /> <-o-- 1 7 - "II <br /> Relin s b Sign lion Dae Time N by ignatur A ilia ion) ate Time <br /> by ( � nature fd atio ) ate Time Received by illation) at Time <br /> Report Tom,./ Z8111 to ULTRAMAR INC <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> Attention <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 326003 im <br />