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r ar rr �r rl� rl� rf �r r it r r r r r <br /> VltrAr Inc. - <br /> CHAIN OF CUSTODY REPORT `� SS BEAN <br /> BeaconStation No. Sampler(Pint Name) Dat Form No./ <br /> ANALYST=S of <br /> Project No. Sampler ature) <br /> Project Lavation �iation � <br /> 0 <br /> - 0 <br /> ��✓ x -- <br /> Lu _ _ <br /> Sam fe NoJldentification Date Time Lab No. m a a rzcoi REMARKS <br /> :Gd <br /> i <br /> _.'0 7 <br /> i <br /> Relinquish (Signature/Affiliation) Date Time Received (Signatu ffiliation) Date Time <br /> uish y: (Sign r filiation) Date Ti ' ejved (Sr nature/A 'li.ati n)'/ Date Time <br /> Relinquisftiy; (Signature/A##ili tion) 15Me Time eceived by ( ignature/Affiliation) a Time <br /> Report To: - ' Bill ULTRAM INC. <br /> /7�1�'.�& 525 West Third Street <br /> Hanford, CA 932 a <br /> }r <br /> 91% - 93 3'-2-/7 j— Attention: <br /> WHITE: Return) to Client with Report YELLOW: Laboratory Copy PINK: Originator Copy 32.6003 IM <br />