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1')at ® P.O. 13E�)I�IZA"!'i��S11I�ANCf � • .", � <br /> Ox 586, Citrus Ileights, CA 95611 <br /> i H C O R Pit R A I E O <br /> CHAIN O F CUSTODY ' <br /> IHi iSSUIIIM C! 01 OU wt1 <br /> Novato, CA, 1 I Digital Dnve, 94949 • -50 <br /> Phone 415) 883-6100 Fax (415) 883-2673 <br /> onsultaut's Name Aegis Environmental, Inc. Natne of Ii►sured Moore Petroleum Page of <br /> ddress 1050 Melody Lane, Suite 160, Roseville, California 95675 federated Site 14800 W. Frontage, <br /> Location Hanteea <br /> ru cct Contact Laura Odentha Phone IY (916)782-2110 Fax.# ( 16)786-7830 Federated Contau Gail Clark <br /> am led b ( rant} c� 1" Sampler s SI nalur Phone !J (9j6)7A?_—?_l 22 Pax N 1916 1729-2129 <br /> lupment Method ,� � Cao-ka�-- Consultant Project a 90-097 Federated Claim M 837-159 <br /> Satl►ple Condltlou as RLCCIVCd <br /> AT ❑ 24 hr ❑ 48 hr ❑ 72 hr VNL Standard(10 day) ANAL YSIS RE UIRED Temperature°C <br /> Cooler N <br /> Inbound Seal Yes No <br /> ca Outhound Seat Yes No <br /> iarnple Descnption ColleUron Matnx Prsv #of PACE <br /> at Mme So►I/Wrter Cont SampleCOMMENTS <br /> „Kk, <br /> V%%Lo t ',fie U <br /> 1v <br /> `l tl,low yl <br /> Relinquished by/Affiliation Date Time Ac a ted by/Aff4ation Dae Time Additional Comments <br /> c� a 4 7 3 y <br />