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M M Ml Ml M IMP M M M M Wl r M M M 7re <br /> awl■ <br /> hone 916 782 211() Send mutts to. <br /> V1050 <br /> X (916)7807830 AEGIS Environmental Consultants, Inc• Aegis Fnvironmental <br /> Sample Identification/Field Chain of Cuslody Record Melod�tanee,CA 9567te 8 <br /> For Steel!1'ro�e�la Only <br /> Site Address- A, 9 —, 7 .s9„�— .�v� ,y"rEr���f— —ewe-- <br /> AEGIS Proect#. APE <br /> — <br /> Shipped By: £ 9h- <br /> Shipped To NJEllrmwr <br /> Protect ManagerSM AZ L Hazardous Materials Suspected?(yes/no) <br /> Sampling Sample No of Analysis <br /> Point Leaslion Field 1D1f Date 7 ype Containers Required <br /> f3QlgE Arra 1"W~ /0—'2 —�L s .cSr <br /> 144trJ- Z <br /> 3 LJ — 3 <br /> � - S <br /> r <br /> Samplers)(signature) <br /> Field ID Relinquished Q (signature) Received B (signature) Dale/Time Comments <br /> S r 1,6 .'/ --blA <br /> Scaled for shipment by.(signatu Datc/Ttmc. f Shipment Method --� Pit,&- <br /> Received for Lab by (stgnmurc) DatefrimciT& obbp Comments <br /> Receiving Laboralory: Please return original form after signing for receipt of samples. <br />