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Laboratories Inc. Jik�_ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1628545 Page 3 of 4 <br /> BC LABORATORIES INC. �1 COOLER RECEIPT FORM Page Of <br /> Submission #: ` ' <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest[3. None ❑ Box ❑ YES NO ❑ <br /> BC Lab Field Service Other❑(Specify) Other ❑(Specify) / S <br /> Refrigerant: IceV Blue Ice❑ None❑ Other❑ Comments: <br /> Custody SealsIce'Chest❑`. Corltalriers O None N1 Comments: <br /> > > <br /> All samples received? Yes -No❑ All samples <br /> containers intact? Yes No❑ Description(s)match COC? yes I - No ❑ <br /> COC Received Emissivity: (�/• t Container: Thermometer ID: Datelfime 11 a� <br /> ( YES ❑ NO Temperature: (A) '. 3 °C / (C ) `C I Analyst Init Za <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 2 3 1 4 5 Q 1 <br /> T PE UNPRES <br /> 4oz/Soz/16oz PEUNPRES ib <br /> 2oz Cr" <br /> T INORGANIC CHEMICAL METALS <br /> INORGANIC CHEMICAL METALS 4oz/Soz/16oz <br /> PT CYANIDE <br /> PT NITROGEN FORMS C C— <br /> PT TOTAL SULFIDE <br /> 2oz.NITRATE/NITRITE _ <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYGEN DEMAND <br /> PIA PHENOLICS <br /> 40m]VOA VIAL TRAVEL BLANK <br /> 40ml VOA VIAL <br /> T EPA 1664 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> T EPA 508/60818080 <br /> T EPA 515.1/8150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 40ml EPA 547 <br /> 40ml EPA 531.1 <br /> 8oz EPA 548 <br /> T EPA 549 <br /> T EPA 8015M <br /> T EPA SZ70 <br /> Soz/16oz/32oz AMBER <br /> 8oz/16oz/32oz JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLARBAG <br /> FERROUS IRON <br /> ENCORE <br /> SMART KIT <br /> SUMMA CANISTER <br /> Comments: <br /> Sample Numbering Completed By: Rate/Time: Rev 21 05/2312016 <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document.This analytical report must be 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: 1000538621 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 6 of 59 <br />