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ftF WHF Environmental Consultants Inc <br /> ��L I— <br /> Post Office Box 6729 <br /> CHAIN OF CUSTODY RECORD Modesto, CA 95355-6729 <br /> (209) 579-8138 <br /> PROJECT NAME <br /> SAMPLERS (signature) Number <br /> of REMARKS <br /> station Can- <br /> Number Date Time o Station Location tanners <br /> U C7 <br /> X 47- li�zn <br /> JZ,' fl ZO` ?�1 <br /> jgo <br /> r L oL4 <br /> I I LX4 <br /> � C <br /> LL <br /> �Re i qui by! tur?) fete / Tine mei ed bi (signature) Rel nquished ty(sigrature) Date / Time IReceiveo by (signature) <br /> �'�- '� Company or Agency <br /> Com�or Agency �+„, Company Agency Company or Arene} P Y g Y <br /> !�'I`7 r lily,-C ri...c.7 f 2 ! ��T7 { -4�:,C _ --- <br /> Relinquished by,signature) Date ! Time Received by (,ianature) Relinquished by °Date / Time Received by Rsignature) <br /> Compan) or Agency Company or Agency Ccmoany or Agency Company or Agency <br /> Reiirigbishpd by(s)gnature) Date 1 Time Received for Laboratory by Date / Time Remarks/Shipp ng information 11 <br /> (signature) <br /> Company or Agency <br />