Laserfiche WebLink
Unramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT <br /> uhernar i <br /> i <br /> Bea=Station No Sampler(Print Name) at EOrm No <br /> k4ci RANALYSES 5 1 of t <br /> Protect No 11 '-xo s 0$ Sampler(Sig to e <br /> Project Location Z,8S f � � Affiliation <br /> � _X Q 0 �tAaopcw `T�o 5 <br /> Sam a No.Ildentificat►on Date Time lab No N L z REMARKS <br /> -5 V 5 wclt 4i,zs- <br /> �� Z 0 40 5a X to <br /> t <br /> Relinquished by �S ature/Affiliation) Date Time ery by to fiilIII Date Time <br /> - <br /> _ LP <br /> Relinquish y igna rel Date ime �i a ign r ate ) Date ime <br /> / t <br /> Re�EngtliS b S uamwitrtw all <br /> Time Rece� ed by ignature/Affiliation) D e Time <br /> Report To Bill to ULTRAMAR INC <br /> 525 West Third Street <br />'h nm�i L Hanford, CA 93230 <br /> Attention <br /> WHITE Retum to Client with Report YELLOW Laboratory Copy PINK Originator Copy ueooeoft <br />