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= L = wf � � � � � � <br /> Phone 0 782 2111) r �+ Send residli t <br /> FAX (916)713&-7834) ` AEGIS Environmental Consultants, Inc. AcglsEnvironmental <br /> _ Sample Identification/l�ield Chain of etls(ody Record 1050 Melly Lane,suite 160 <br /> �O�!w <br /> Roseville,CA 95678 <br /> 1�vr Strctf 1'rr►jeclti Only <br /> SileAddress• L PtC- Ak Srot 0-hp , (:!,Awi . zu4 �z5 -� LAEGIS Proaoct ll D�u _ <br /> AF-E <br /> Shipped By Rt, l S <br /> crrDl. - l <br /> Shipped To-�.. 0P FtL <br /> Shcll Engineer J 't' o1_o <br /> Project ManagerDA�� _MSU LS�� _ Hazardous Materials Suspected?(ye® <br /> no <br /> Sampling Sample No of Analysis <br /> Point Location Field 1011 Date 7 ype Containers Required <br /> ( Olt IC' fr <br /> PEt4 JbML CcU Li-1 <br /> tM�_ L Vixw -Z y <br /> Sampler(s)(signalurc) rAd <br /> Field ID ' si tial e) Re eived R (signature) Daletrime Comments <br /> X ok S ! <br /> Sealed for shipment by (signature) Dale/f imc I i J Shipment Method '�( ti v c L <br /> Roccived for Lab by.(signatur a Dat 6-00-92ft '� <br /> _� ._ c/Tlmc� � ommcnls <br /> r Receiving Laboratory: Please return urigirml Germ after signing for receipt or samples. <br /> Whdd0F181nd Yellow/i A Copy 1'111k/I do Copy <br />