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- <br /> Phonf,(916)782 2110 � � Stnd retiult%to <br /> rAX (916)786-7811) AEGIS Environmental Consultants, 1110. AegisFnvtronmenlal <br /> Sample Identification/ field Chain of Ctis(ody Record �, sol Roseville, <br /> C,Suite <br /> '-'� � ' Roseville,CA 9S67f1 <br /> _ A For, ell f'roJe�tti Only <br /> St1c Address r��('('_ l� � i!��(�� ...-..il"�,aNj'F �.a �, <br /> --- -..�. . ... WIC <br /> AEGIS Project# - `'� `t AFE ` <br /> { <br /> Shipped By I CT/DL \�- ------- <br /> Shipped To `tf 7 „ Shell Engineer <br /> Project Manager ��� ��1 1` 1 d1 l \ <br /> J g Hwardous Materials Suspected?(yes,/no)_ <br /> Sampling << I r . 4•' ih c <br /> Sample No.of Analysis <br /> Point Location Field IDN Date 7 we Containers Required <br /> t�--tSptt � CVc 'rrF <br /> i <br /> i <br /> Sampler(s)(signature) <br /> Field ID Relinquished fly(signature)✓ Received fly(signature) 4- 1 Dateh ime Comments <br /> Scaled for shipment by (%ignalure; �`� r Dal,-[I imklh r r �{ `��``` Shipment Mclhorl <br /> Received for Lab by (signaturc) Dalc/I nnc W kilk? o,''C'(, Comments <br /> Rttciving t aboralory Please relurn origin, m alter sigittng for receipt of samples <br /> YW" 11) dil"11c f takm tttttttt� t� t♦ <br />