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Send results to; <br /> Phone(916FAX (916))786 782 2110 0 AEGIS Environmental Consultants, Inc. Aegis Environmental <br /> Sample Identification/Field Chain of Custody Record 801 Riverside,Suite C <br /> P Roseville,CA 95678 <br /> For Shell Projects Only <br /> Site Address: M b k Z l -v t 5[, �Atil T,4 Com- <br /> AEGIS Project t ' 0 <br /> Shipped By: <br /> Shipped To: <br /> Project Manager. ( D-22 l.��MNt CIZL!nl(� S j - Hazardous Materials Suspected?(yes//no) <br /> Sampling Sample No.of Analysis <br /> t`1C L l� 1 Point Location Field 1D1i Dale TvDe Containers Required <br /> 41 <br /> t Ai U J 4 i LJA re I $z7O , ?4CA(11 w.1S <br /> Sampler(s)(signature <br /> Field ID in uish ( ' nature) Recei��ed By(signature) Date/Time Comments <br /> I S LI i" <br /> Sealed Tor shipment by: (signaturekil Dalef ime:qqoe Shipment Method: /0 <br /> Received for Lab by:(signature) Date rine: 5, Comments: <br /> :ITal -� � LIT41� n <br /> H - f b CU Pg'� A�VC vYk <br /> Receiving Laboratory: Please return original Corm after signing for receipt orsamples. _ <br />