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WIIF Environmental Consultants Inc. <br /> Post Office Box 6729 <br /> CHAIN OF CUSTODY RECORD Modesto, CA 95355-6729 <br /> (209) 579-8138 <br /> PROJECT NAME: <br /> •'� b <br /> SAMPLERS (signature) c° o� <br /> Number Q�� <br /> of REMARKS <br /> Station Cori- <br /> Number Date Time Station Location tainers <br /> U to <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by(signature): Date / Time Received by (signature): <br /> Company or Agency: Company or Agency: Company or Agency: Company or Agency: <br /> Relinquished by(signature): Date / Time Received by (signature): Relinquished by: Date / Time Received by (signature): <br /> Oil Company or Agency: Company or Agency: Company or Agency: Company or Agency: <br /> O ---- <br /> Relinquished by(signature): Date / Time Received for Laboratory by: Date / Time Remarks/Shipping Information <br /> (signature) <br /> Company or Agency: <br />