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Phone(9IG) 1!2 21111 Send resulls lo• <br /> FAX (910)786-7830 AEGIS C»virclimieWal Consultants, Inc. AegisFrivironmenial <br /> Sample Identification/Field Chain of Custody Record 801 Riverside,Suite C <br /> r <br /> Roseville,CA 95678 <br /> / <br /> For Shell Projecls Only <br /> Site 44 <br /> le Address 4 LAL'r- Stec'W-Vo1y (519 <br /> AEGIS Project U u1O- d L{ <br /> Shipped Byte'-S �)t. <br /> Shipped To, _` hagm '4- S 4e- _. Shell Engineer 1 --+►1/-, <br /> Project Manager 'AL3 LG.ti.-fEtftrr✓!r _.... lWardous Materials Suspected?(ycs/no) <br /> Sampling Sample No,of Analysis <br /> Not Localkin Field IDU Date Type Conlainers Rectuired <br /> ? 7-07A4 �Lw <br /> — <br /> 11 <br /> Will rE� � cvia� <br /> M Lf� Z.1SZ) <br /> C L14� <br /> � c CWA <br /> Samplers)(signature) <br /> Field ID Relinquished R (signature) Received 11 (signature) DaWIime_ Comments <br /> Scaled for shipment by(signature f I Ar <br /> ` 1-- - Shipment Mcdial- h L1lL <br /> Received for Lab by(signature Daleffime ,ll7 Comments <br /> Receiving I abormory• Please relurrr original form alter sipnina ror receipt or sample% <br />