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Vlftamar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT <br /> Beacon Station No WVA Sampler(Print Name) Date PForm No <br /> FQD Co,5 ANALYSES °+l S I of t <br /> Project No Sampler(Signature) <br /> 1°1oa5 to <br /> Project Losartan Affiliation m <br /> S'toC..t-'Car�1a Com- � <br /> � STntappRfl 'SAS <br /> 0 <br /> Sa a NoAderilfication Date Time Lab No n a REMARKS <br /> Zt ��tiS�q� 12:t7r, XX <br /> Its q'4 <br /> -H I I I DATE ` f� <br /> rr�ry Bf 'L_ <br /> lf-3l i lij <br /> WESP LAV <br /> Relinquished by ( nature/Affiliation) Date Tune R iv S Date Time <br /> RelinquAedS ;� <br /> ( Date Time ry y Afi alio ate IM <br /> i <br /> Ref is rel ` ate Time Received by (SignaturelAffi ) e Trme <br /> Report 70 <br /> -51 V- Brtf to IJLTRAM <br /> AKINC- <br /> 525 West Thad Street <br /> "nv�-14.}L Hanford, <br /> CA 93230 <br /> Attention <br /> WHITE Retum to Chent with Report YELLOW Laboratory Copy PINK Originator Copy 32-M p <br />