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tttttt, � t1111111>I � � I• � � � r• r• � � � � � � <br /> Phon (x)16)782 2l 1(1 Send results to.� <br /> FAX (x)16)7t;6 7133(? AEGIS Environmental Consultants, Inc. S'c�o� Aegis Environmental <br /> Sample Identification/Field Chain of Custody Record 801 Riverside,Suite C <br /> Roseville,CA 95678 <br /> ` r <br /> For Shell Pr)ects Only 5 <br /> Site Address + (.t C'_ -'� - WIC <br /> AEGIS Project# (76' — b — AI:E <br /> Shipped By 4 C, S CT/DL f <br /> Shipped To Shell Engineer. <br /> Protect Managerg T Hazardous Materials Suspected? (yes/no) <br /> Sampling Sample No.of Analysis <br /> Point Location Field ID# Dale .rype Containers Required <br /> hC� i <br /> -rph 5 , <br /> jUO I ULP I U l <br /> •* rsrw.iaa.ail116 <br /> Sampler(s)(signature) t <br /> Field ID tinquished By(signature) Received By(signature) DalelTrme Comments <br /> S' y� <br /> Scaled for shipment by (signature)TN N AA � Date/1'ime .�`�d" %� Shipment Method. <br /> Received for Lab by (signature) le, ad Datc/rur e _ //r t'/-T Comments. <br /> Ruervrng Labor.rtory: Please return oregurdl roan atter signing for reLerpt or s.rmpies. <br />