Laserfiche WebLink
i IJltr � • <br /> amar Inc. 13EAC®N <br /> t nrarnwg <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No Sampler(Print Name) Daterm No <br /> 'J ANALYSES ('0 `�1Z- �'-- <br /> of <br /> y 13 a r e <br /> Protect No Samp r( ignature) <br /> Project Location Affiliation G -- <br /> //__ <br /> a U c <br /> w = = ° <br /> Sam le Noildentification Date Time Lab No m a z° REMARKS <br /> t9-13 -Y�5 r <br /> 70 <br /> 13 -9'-5 L <br /> -9113- <br /> 133 - A 0 <br /> Relin uished by (Signature/ ffiliatign) Date Time Recei y nat ffilia Date Time <br /> Relinquish ( A iati ` Date Time R iv by Signa ur ffdiation) Date Time <br /> 3/ <br /> Relinq ignaturelAffi io Date Time Received b r dragon) Date Time <br /> � Y <br /> Report To o ULTRAMAR INC f <br />� CT <br /> 525 West Third Street <br /> f Hanford, CA 93230 <br /> Attention - -r,�/r ,, rrr.•�S� <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy 32 6003 1R0 <br /> i <br />