Laserfiche WebLink
Ultramar Inc. <br /> BEACON <br /> CHAIN OF CUSTODY REPORT <br /> t <br /> Beaoon Station No Sampler(Print Name) Date �J l= No. <br /> l I /-/., ANALYSES /�' of ! <br /> l �s C:3 <br /> Protect No Sampler(Signature) La <br /> CD <br /> Project Location W Affiliationcc <br /> .- 5 PTI (Dv m c <br /> ; � O r ObLD . I F <br /> O <br /> Sarryle NoAdentincation Date Time Lab No1;z I c REMARKSIL r <br /> W .101-- � - ,� -% �. .�.� T. 131 <br /> vi z 1 <br /> A-- I <br /> Relinquished by (Signature/Affiliation) Date Time Received b (S I Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Reoe y ( nature/A that n) Date Time <br /> Relinquished by (Signature/Affiliation) Date Time Received by (Signature/Affiliation) Date Time <br /> Report To Bill to ULTRAMAR INC <br /> f',v 1/ T I 1 525 West Third Street �r <br /> / Hanford,CA 93230 <br /> rj5qo Attention <br /> WO Return to Client with Repod YELLOW Laboratory Cop PINK Originator Copy 1A0 <br />