Laserfiche WebLink
l <br /> Ultramar Inc. g C 01" ' <br /> ,�-,- EAC�N <br /> CHAIN OF CUSTODY REPORT <br /> unraE,�ar <br /> Beacon Station No. Sampler(Print Name) Date Form No, <br /> ANALYSES lk- J of <br /> Project No. Sampler(Signature) <br /> Project Location G.tc Affilialion oEn 0co v <br /> o <br /> w = = // <br /> Sam le No./identification Date Time Lab No. m z° REMARKS l <br /> AA vJ <br /> We <br /> Relinquish by: (Signature/Affiliation) Date Time Ree i y: (S a u /Aff'' n) Date Time <br /> IQ- <br /> Reli a filia i ) Date Time ec ed y: Signature/ Date Time <br /> ed y: ( ign r Affilia ton) Date Time Received by: (S' ure pt#ilia ' n) e Time <br /> Report To: Bill to: TRAMAR INC. <br /> 525 West Third Street <br /> Hanford, CA 93230 <br /> Ta - i)-77 Attention: .._.__�Q�r,�n.p /(, 1 �•r r�.Q `. <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy 32-80031M <br />