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Unramar Inc. BEACH.�,`N , <br /> qUnrma1nnwM <br /> CHAIN OF CUSTODY REPORT <br /> Sampler(Print Name} D t f=orm <br /> Beacon Station No. ANALYSES of <br /> Project No. Samples Signatur ) `�,�•� �� <br /> L <br /> Pro ect Location Affiliation N �; oLD 0 <br /> cn-0 <br /> Env 1 e"))-n r) xLij z r ° <br /> m � r <br /> Sample No_lldentification <br /> Date Time Lab No. z REMARKS <br /> 7-5 s—,4 A" 3 <br /> i yrs <br /> 6 , 5010f <br /> 4 <br /> S ",6 <br /> NO <br /> ►1 ) <br /> • <br /> Date Time <br /> Relinquished by: (SignaturelAffiliation) Date Time <br /> Date Time Received by: (SignaturelAffiliation) <br /> Relinquished ( ignature/Affiliation) <br /> Date Time Received by: (SignaturelAffiliation} - - <br /> c� Date Time <br /> Relinquished by: (Sig naturelAffiliation) Date Time Received by: (Signature/Affiliation) <br /> Rill to: ULTRAMAR INC. <br /> I <br /> Report To: G,a '�y-'O .t'r2 525 West Third Str et <br /> 1�r� i r.u�e2���En/ 't J✓+�� <br /> SHanford, CA 93230 1 <br /> c',X77 <br /> 5'l�:l C�Cr�t�1E� ✓I 7.r11�1 �. ,t--Al Attention:^J �rr1�1JLL �N30h <br /> �z- ,�� /Y�4,./ ! �� S•/ � a� 32-80631!90 - <br /> WHITE: Return to Client with eport YELLOW: Laboratory Copy PINK: Originator Copy <br />