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ild <br /> Laboratories, Inc. <br /> _ Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1300562 Page 4 of 4 <br /> G LABORATORIES INC. COOLER RECEIPT FOTM Rov.No. T3 00117112 <br /> uklnli�siorl K: �O <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> edaral Express 0 JPS a Hand Delivery ❑ Ice Chest None Q <br /> C Lab field Service 01her❑tSpecilyl Box 0 03her ❑ISpecifyl <br /> Refrigerant: Ice p? Blue Ice ❑ None❑ Other❑ Comments: <br /> ustody Seals Ice Chest❑ Containers❑ Nonep? Comments: <br /> 11 samples received? es NO p All samples containers intact? r 1110❑ Descriptionlsl match COG? Yes 0 4-G� <br /> Gori Receive EEmisshMY.' rC Container: C T Thermomeler ID: 00 patelTima - ?^I?` <br /> 99YES ❑ NO <br /> erature: I A 1 1.�( °C I (C i f °C Analyst Inti cItJL�3 <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS ( 3 2 f3 4 5 s 7 s s 10 <br /> T GENERAL mWERALI GENERAL PHYSICAL <br /> PCUNPRESERVED <br /> T IMRCANIC CHEMICAL METALS <br /> INORGANIC CJIEMICAL&ST"S <br /> CYAN lDE I <br /> rT'NITROGEN FORMS <br /> r Tq'I'AL SUI.FIBE <br /> z.NITLAT'E/IVITRTI'E <br /> "T TOTAL ORGANIC CARBON <br /> PT TOO <br /> l'r CHFMICAL OXYGEN DEMAND <br /> FLA PHET40LICS <br /> 40m1 YOA VIAL TRAVEL BLANK <br /> 4Bnr1 VOA VIAL <br /> T EPA 413.1 41IL 415.1 <br /> PT oM. <br /> RADIOLOGICAL <br /> BAC11ERI0LOGICA.L <br /> 40 nil VOA V IAL-504 <br /> T FPA 511BI(PORA1068 <br /> T EPA 315.US 150 <br /> T UA 525 <br /> T EPA 524 TILAVEL BLANK <br /> IODO)EPA 547 <br /> WOW HrA 531.1 <br /> T EPA 549 <br /> EPA 547 <br /> T EPA 02 <br /> T EPA 50151%4 <br /> T AAM ER <br /> B 02-JAR <br /> 33 OL JAR <br /> SD rL SLRE V L� <br /> PCB VIAL <br /> I'LASTICIIAG <br /> FERROUS IRON <br /> ENCORE <br /> SMART NUT <br /> Comments: <br /> Sampla Numbering Completed By: Daie/Teme: <br /> A = Actual t C = Corrected <br /> The results in this report apply to the samples analyzed to 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 /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 6 of 28 <br />