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i <br /> Laboratories Inc. <br /> ' Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1414263 Page 2 of 2 <br /> t ,ABORATORIES INC. COOLER RECEIPT FORM Re,No. 17 06/05/14 Page Of <br /> Submission #: (�l^ a`3 <br /> t SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Federal Express ❑ UPS❑ Hand Delivery ❑ Ice Chest None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service Other❑(Specify) Other ❑(Specify) <br /> Refrigerant: Ice Blue Ice L7 None❑ Other❑ Comments: <br /> Custody Seals Ice Chest LTi°, Containers❑ Non Comments: <br /> All samples received? Y.R: —No❑ All samples containers intact? YosZli-'No❑ Description(s)match COC? Yes j, No ❑ <br /> OC Received Emissivity:0-11911 Container: 14s te/ <br /> Thermometer ID: e"� DaTI-4142 �� <br /> yf -)130 <br /> OCYES ❑ NO Temperature: (A) ,- 'C l (C ) ( -S "C Analyst Init P <br /> SAMPLE NUMBERS <br /> ' SAMPLE CONTAINERS <br /> 1 2 3 4 6 6 'J 8 1 9 1 10 <br /> T GEN'ERAI.MINERAL/GF.NF.RAI. <br /> PT PE II,NPRFSFRVED <br /> 'f INORGANIC CHHMICAL MFTAI.S <br /> t PT INORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2oz.NITRATE/NITRITE <br /> Pr TOTAL ORGANIC CARBON <br /> FI'TOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> ' PtA PHENOLICS <br /> 40.1 VOA VIAL TRAVEL BLANK <br /> 40mi VOA VIAL I 1 I I 1 I I I I t <br /> 'f EPA 413.1 413.2 418.1 <br /> ' <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTER101.0GICAL <br /> 40 ml VOA VIAL.504 <br /> ' T FPA 508/6088080 <br /> 'f EPA 515.18150 <br /> CT EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> ' 40.1 EPA 547 <br /> 40ml EPA 531.1 <br /> Boz Amber EPA 548 <br /> T EPA$49 <br /> ' T EPA 632 <br /> T EPA 8015M <br /> T AMBER i <br /> 8OZ.JAR <br /> SOIL SLEEVE <br /> PCR VIAL <br /> PLASTIC BAG <br /> ' FERROUS IRON <br /> ENCORE, <br /> SMART KIT <br /> ' I Sununu Canister - <br /> Comments: <br /> Sample Numbering Completed By: Date/Time: I lS:1WPNo<Word Perf•ctlLAe OOCSIFORMSISAMRECI6 <br /> A = Actual / C = Corrected <br /> s <br /> the results in this report apply to the samples analyzed in accordance with the chain at custody document.This analytical report must he reproduced in its entirety. <br /> All results listed in this report are for the exclusive use of the submitting party. BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID. 1000269391 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 19 <br />