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(916)782211" AEGIS Environmental Consultants, Inc. <br />FAX (910) 786-783(i Sample Identification/Field Chain of Custody Record <br />Site Address: <br />CT r7 <br />AEGIS Project <br />Shipped By: <br />Shipped To: <br />Project Manager <br />Sampling Sample <br />11dak ID. -NA In* n.i. Wwna <br />Send results to: <br />Aegis Environmental <br />801 Riverside, Suite C <br />Roseville, CA 95678 <br />For Shell Projects Only <br />WIC: <br />AFE: <br />CT/DL: <br />Shell Engineer: <br />Hazardous Materials Suspected? (yes/no) <br />No. or Analysis <br />Vantskinare Rommir" . -) <br />sampler(s) (signature) <br />Rod-pswpd Rw Wanzatearel <br />Daterrime Comments <br />-7 777-7 <br />AV <br />70 <br />—get <br />sampler(s) (signature) <br />Rod-pswpd Rw Wanzatearel <br />Daterrime Comments <br />Sealed for shipment by: (signature) Date/time: 7 Shipment Method: <br />Received for Lab by: (signature) Date/Time: Comments: <br />e — <br />'k <br />Receiving Laboratory: Please return original rorm arter signing for receipt or samples. <br />Whilt-K)rioinal Ycllowfiab C(mv MANdc Corw <br />-7 777-7 <br />Sealed for shipment by: (signature) Date/time: 7 Shipment Method: <br />Received for Lab by: (signature) Date/Time: Comments: <br />e — <br />'k <br />Receiving Laboratory: Please return original rorm arter signing for receipt or samples. <br />Whilt-K)rioinal Ycllowfiab C(mv MANdc Corw <br />