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allI <br /> f <br /> Send rrs'ulls to: <br /> Phonc(916)7822110 ,E��CiIs Environmental Consultants, Inc. Aegis ravironmental <br /> FAX (916)786.78311 SOI Itirerside,Suiile C <br /> Sample Identification/ ield Chain of Record liosevilte,CA 95675 <br /> For Shell Prajarli Only <br /> Silo Addn:ss:/�%yz'E <br /> AFE: <br /> AEGIS Project 1: - CTIDl.: <br /> Shipped By: Shell Engimc cr: <br /> Shipped To: — hazardous Materials Suspxtal?(YCThm) <br /> Project Manager LSr'H <br /> Sample No.of Analysis <br /> Sampling Field Il}tt Date T a Containers Required I <br /> Point Location j/-1 Gess <br /> EYda- 5�,auJw� fr- _ Cat=23�g1 tA 3 EQe3 not t �Z <br /> W-' 3 M -� <br /> b <br /> Sampler(s)(signature) Date/Time Comments <br /> Field 11) Min uished It (si nalure) Received B (signature) <br /> Sealed for shipment by:(signatu <br /> ° Datc(Time: g -QJ�~ Shipment Mcrhod: <br /> yl�el �1fD <br /> a � 1 f <br /> Received for Lab by:(signature) DatO'ime: Comments: <br /> � ,_,•,� U _�/F':�' f 9 i <br /> Gi <br /> Receiving I.aboralory: Please return original form after signing fur receipt orsamplrs <br /> �i <br />