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t 11111111111 �� � { � Uttttllll � i � <br /> phanc(t)16} Ill) ALMS 1Cnvironinen Consultwits Inc. Send result to <br /> FAX (915)786-7830 Aegis 1'ronmenl.il <br /> Sample Identification/1+ield Chain or Custody Record Sul fe, ille,C,Suite 8 <br /> Rose►illc�CA 95478 <br /> kor Shell I' CIS Only _ <br /> Site Address r LlhC AVE- WIC - <br /> AEGIS Project N. —G `AIT-- <br /> Shipped By: ACl/DL <br /> Shipped To s Shell Engineer KURT M �� <br /> hrolecl Manager E Hazardous Materials Suspected?(yes/no) <br /> Sampling Sample No of Analysis 1 <br /> Point Location A/1Field ID# DateO , 7 Yoe Containers Required <br /> J _ / SGall , !31 vifii, —L" ` _ 7" ��" it UATEIL I c� <br /> 14, <br /> M >, 1 <br /> A <br /> Sampler(s)(signature) acv 5 J <br /> MIA 1D Relin uished Uy(signature) Received R (signature) Date1l We Comments <br /> r <br /> Scaled for shipment by.(signatu DaWsmShipment Method. <br /> Received for Lab by.(signatu DJte/i imc•� <br /> Comments <br /> I <br /> Rei.eiving Laboratory: Please return original form after sigp-rn,for receipt or samples <br /> Whue/ongmal YcllowA-eb Copy NAP Jc Copy <br />