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■�• � �� �R a� v � � i• f• ii• si• iiiii•�ii� ii• <br /> [VqiF 1� Q5Z1 <br /> WHF Environmental Consultants, Inc <br /> Post Office Box 5729 <br /> CHAN Of CUSTODY RECORD Modesto, CA 95355-6729 <br /> (209) 579-8138 <br /> PROJECT NAME: <br /> C/ lilyN QD <br /> SAMPLERS (signature) 4� <br /> Number V4, <br /> of REMARKS <br /> StationCL <br /> / <br /> Number date Time b Station Location Con- 1 <br /> U (5 tamers <br /> 5bo k ' <br /> Z X X <br /> 03 x <br /> s x <br /> 5qo W d X <br /> - 1 k <br /> Re?nquby ign ure) pate / Time s gna ure) Relinquished by(signature) Date Rec ved by (signature`�1�Co Company r A e c <br /> 3U y• c ompany or Agency• <br /> ttJL. <br /> Reit fished by(si natur ) Date / Time Sued b ( ign tore): quis y Date / Time Received b <br /> y (signature)- <br /> Y' <br /> _r Agency ct. ��� Mare an Qn --c. ► ?� i��1�w�C �� <br /> Y6 g Y. om any `gent Company or Agency: <br /> Relinquished by(signature) Date / Time Received for laboratory by Date / Time Remarks/Shipping information <br /> Company or Agency (signature) <br /> e—Z <br />