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Unr ar Inc. BE N <br /> CHAIN OF CUSTODY REPORT <br /> ut�rnr <br /> @eac,on Station No Sampler(Print Name) Date F rm No Z <br /> q <br /> / AN YSES of <br /> Cj O <br /> r <br /> Project No Sampler( alure) S <br /> Project Location Affiliation - 5 <br /> N o <br /> P1,90 U L cj <br /> Sam le Noildentification Date Time Lab No m z° REMARKS <br /> vw - 3-I-o0 jo et- q( � 3 <br /> r vw - -7 l/ ll ,• l� - to <br /> HL I I <br /> 11 <br /> Reli i hod y (Sig t Afliliation) Date Time Received by (Signature/Affiliation) <br /> Date Time <br /> - <br /> u (Signature/Affiliation) Date Time Received by (Signature/Affiliation)- Date Time <br /> ------------ <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) Dale Time <br /> X" INf <br /> Report To Bill toLTRAM INC <br /> 525 WeXtThird Street <br /> "! Hanford, CA 93230 L l <br /> Attention �� <br /> WHITE Return to Client with Report YELLOW Laboratory Copy PINK Originator Copy <br />