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J <br /> V. <br /> Phone(916)782'x 1111 Send mmults to; <br /> FAX (916)786.7.8,311 AEGIS Environmental Consultants, Inc. AegbiEnvlrowmcntal <br /> 1050 dlelotly lane,suite 160 <br /> Sample I(1cI141I•ilation l+ielcl Chain of(llsals(ly.�tccrlr( Ncrscwlllc,Ca9567N ' <br /> ! �$ o���' I <br /> r I or S t 'rujccts Only <br /> Site Address: l` i ...r ... t_ _ r 1GG_ . WIC: <br /> i l0_ CtZ'GC'1C / 33'Z-!&R <br /> ALG15 Project g: Aim: <br /> shipped 11y: S F, 1 CT/DL: <br /> ShiTo: �C �ZNI Z ,%4 <br /> pped i .�.. Shell En*' r. <br /> 5�i' c <br /> Project Manager'�G � 1 Ilan: ous Materials Suspected?(yes/no) } <br /> Sampling Sample No.of Analysis AX <br /> Point Location Field lD# Irate TVpe Containers Required t4 <br /> TN <br /> 11"I Li-1-)� lulls.. 44- <br /> ISI w <br /> i <br /> Sampler(s)(signature) ��� � 'lT' ( • ��!) cL!vl ML <br /> wield ID Relin u'shed it (signature) iteceived By(signature) Dale:'Cimg Comments <br /> �— <br /> I <br /> i <br /> j <br /> Scaled for shipmeni by:(signal t� C ] -rte D Ialfim�1/'S Shiprncnl Mcthcx 5 ecj�tiL <br /> Received for 1_:tb by (signature) talc/1'imc: )—' ��� �omtucnls: <br /> -:iter.-r7�` s`, •.�•_.i .i:HE: r,_:i •fn.p r .. i <br /> -- -- j Receiving Laboratory: 1'Icasc return drrigival form al'!cr signing for receipt ol'sangiles. - , <br /> . W'ha,.rr�.� �n"d Y..q.,..71 ,r,r•..... r•' ,n:.r.. ... <br /> I - <br />