Laserfiche WebLink
_ unrall4w Inc. BEAN <br /> CHAIN OF CUSTODY REPORT <br /> Man= <br /> I <br /> Beacon Station No. Sampler(Print Name) Date Form No. <br /> L < L ANALYSES 1 of � <br /> '7� / vc= r"-1 <br /> Project No. Sampler(Signature) f- <br />� -vim <br /> Project Location Afitialioii _c "` •°`c`' <br /> 1 <br /> •o � c �� ��R ✓ � G—� <br /> N <br /> C. M "SlL <br /> t-jX -- <br /> :s o <br /> I� <br /> TM <br /> L Sample NoAdentiiication Date Time Lab No. }�- a z° REMARKS <br /> 4 1 <br />�F <br /> A <br /> I It} <br /> F <br /> C <br /> E <br /> r Relinquished by: (Signature/Affiliation) Date Time Received by: (Signature/Affiliation) Date Time <br /> dnquiah6d by:(Sig at r&AAflil'aiion) Date Time Received by: (Signature/Affiliation) Date Time <br /> Relinquished by:(Signature/Affiliation) Date Time Rec%v�f y: (SignaturelAffiliation) ime <br /> Report To: <br /> Bill o: 1JLTRAMAR INC. <br /> 525 West Third Street <br /> Hanford, CA 93230 ZG <br /> A(4 , I .. <br /> v Attention: :" <br /> 32-6W3 IM <br /> WHITE: Return to Client with Report YELLOW: Laboratory Copy PINK:Originator Copy <br />