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Phone(916)7 211tl ` <br /> 0 <br /> FAX (916)7W7830 AEGIS Environmental Consultants Inc. Send results t� <br /> � AAegisl:nvlro►nrnenl.d <br /> Sample Identification/Field Chain o#'Cu%tody Record LEI- 01 Riverside,Suite C <br /> CF/OiN �� <br /> How I ille,CA 95678 <br /> M tihelE 1'ro,Icc15 Only <br /> Site Address q01 L 1�f << �r9, L f)vT 1}�r�1lLl. (� W1 <br /> AEGIS Project# - `� ACE <br /> Shipped By -t ! S CI/DL <br /> Shipped To Shell L'nglnur <br /> Project Manager Ak I �z�y� c z� �_..._ I lar trdous Materials Suspected?(yes/no) <br /> Sampling Sample No of An.11yslls <br /> Point Location Field ID# Date 7 e Containers Required <br /> Tf'Nl. G f G,' r7'm� D <br /> i�n _ ° ! J� I r� 0 S Tc I�1 Lr-cf� <br /> —1 s <br /> I <br /> Sampler(s)(signature) -- <br /> Field 1D Relinquished By(signature) Received fly(signature) D.tie/I ome Comments <br /> /-' A Q ! <br /> IC 14 'L Igo-1l5 ` r'i'�e"� , '?lam / r' n/! (:.1_ �`i � /J r 3 <br /> I <br /> Scaled for shipment by (signature) //' �} Dale./l inic Shipment Method <br /> Received For Lab by (slgnature) w.f.11C't Date,fl ime �y 73 Z,yrM Comments <br /> Q� <br /> Ruuving Laboratory Please return original form after signing for receipt of sampics <br /> W1ul1ln1q ink] Y{llowfl ih(npy 1"'4?111, ( xw <br />