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Ultramar Inc. BEACON <br /> CHAIN OF CUSTODY REPORT <br /> loultrammor <br /> Beacon Station No. Beacon 474 Sampler(Print Name) Date Form No. <br /> ANALYSES - t of <br /> Hal Hansen <br /> Project No. 94-474-01 Sampler(Signature) j <br /> ✓� .4 CU <br /> - E � 1? I <br /> Project location Affiliation Douios Environmental o y j ' <br /> W o <br /> Stockton M 'W V <br /> F- L' o <br /> 2 <br /> Sample No./Identification Date Time Lab No. m RE=MARKS <br /> 12901-01 <br /> -2 7, .' 12901-02 <br /> MW-3 J/ ��-1 12901-03 <br /> i� <br /> 12901- <br /> 12901- <br /> 12901- <br /> 12901- <br /> 12901- <br /> Relinquished <br /> 2901-12901- <br /> 12901-12901-12901- <br /> Relinquished by:(Signature/Affiliation) Date Time Received by:(Signature/Affiiliation) Date Time <br /> Relinquished by:(Signature/Affiliation) Date Time Received by:(Signature/Affiliation) Date Time <br /> Relinquished by:(Signature/Affiliation) Date Time Received by: (Signat i on) te, Time <br /> Dale van Dam <br /> Report To: Bill To: ul ramar <br /> E1 Dorado Environmental 525 W. 3rd Street <br /> 2221 Goldorado Trail Hanford, CA 93230 <br /> El Dorado, CA 95623 Attention' Terry Fox <br />