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Phone(916)782 2110r, Send results to <br /> FAX (916)78(-7830 AL[SIS Environmental Consultants, Inc. Aegis cnvlronjnental <br /> Sample Identification/Field Chain of Custody Record 1050 Melody lane,Suite 160 _ <br /> RosevWe,CA 95678 <br /> Site Address r-&1Ae5 l 4��''�4S ��` 7 L Y&3e�, �� I �k+��e� r� � For Shell Projects Only <br /> AEGIS Project# cl 3—&i WIC <br /> Shipped By _._ &xC_le IC lip <br /> - -- CT/DL <br /> Shipped To x e kC tib Shell Engineer <br /> t Project Manager L Vn 111 -2_ _ - Hazardous Materials Suspected?(yes,/no) <br /> Sampling Sample No of Analysis <br /> Point Location Field ID# Dale TyRe Containers Required <br /> Sampler(s)(signature) <br /> Field [D Relinquished lEly(signature) Reteived BY(Signature) Dale/l lune Comments <br /> Scaled for shipment b l� LM1 l (°Z 7 t "�� <br /> p y (Signature) Datejl rine G i ��� Shipment Method <br /> Received for Lab by (signature) Date/[inic V03 5'.3 3 36 9 Comments <br /> ? Rueiving Laboratory. Please return original after signing for retetpt of samples. <br /> VVI if. 4 V 11 /l 4 ! I ' 't , / w <br />