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Laboratories, Inc. 16 <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1014400 Page 4 of 4 <br /> BC LABOFLATORIES INC SAMPLE RECEIPT FORM Rev.No.12 051241QB Page 0 Of g <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> FLFodwal Express O UPS O Hand Delivery 0 Ice Chest ° None 0 <br /> ab Field Service l Other❑(Specify) Box O Other O.(Specify) <br /> Refrigerant: Ice Blue Ice❑ None O Other 0 Comments: <br /> Custody Seals Ice Chest❑ Containers❑ NoneCommeDls: <br /> Inlacl7 Yes Nn❑ Inucli Vey No ❑ <br /> All samples received? Yes No All samples containers inmcl7 YrrrFe�����!��` ,,��,,,,,,,,,,,,,,,No❑ Descripliords)match COC7 Ye o ❑ <br /> COC Received Emissivity: ,,�� <br /> y11 Container ThermometerlD:tl9� Daterrime tG-13-1I7 <br /> BYES 0 NO 7emperalure:A a _` 'C 1 C a. .I -c Analyst Inil,lr7�,J �Iw <br /> SAMPLE CONTAINERS 1 2 a 14 i s l e 2 e 8 is <br /> OT GENERAL MINERAU GENERAL PHYSICAL <br /> PT PE UNPRESFAV¢O <br /> T 21011CANIC CHEMICAL METALS <br /> PT ENORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FO11M5 <br /> PT TOTAL SULFIDE <br /> 2—Nr1j ATE I PDTIUTE <br /> "T TOTAL ORGANIC CARBON <br /> PT Tax <br /> PT CHEMICAL OILYCEN DEMAND <br /> PIA PHENOLICS <br /> 40.1 VOA VIAL TRAVEL OIANit <br /> 40.1 VOA V%&1 <br /> T EPA 413.1 413.2 418.1 <br /> PT ODOR <br /> RADIOLOGICAL - <br /> DACi£RIOLOGICAL <br /> 40 m1 VOA VIA1.504 <br /> T EPA 5I 0/608/8080 <br /> T EPA.515.U8150 <br /> T EPA US <br /> QT EPA 528♦TLA VEL DI.ANR <br /> 100.1 EPA 541 <br /> 100.1 EPA 531.1 <br /> T EPA 548 <br /> TEPA549 <br /> T EPA 622 <br /> T EPA 8015M <br /> T AMBER <br /> 8 OZ JAR <br /> 32 OL JAR <br /> SOILSLEEVE <br /> PCO VIAL <br /> PLASTIC "- <br /> FERROUSIRON <br /> ENCORE <br /> Comments: <br /> Sample Numbering Completed By: DmeRlma: LP. <br /> A=Actual I C=Corrected - IH:InnCSIWVeeIUB p0051FDRM515PMRELZWPo <br /> The results in this report apple to the samples unaljned in accordance with the chain of custody document. This analytical report must be reproduced in ifs entirety. <br /> All Tesults listed in this report are for the exchrsive use ofthe submitting party BC Laboratories,Inc,assumes no responsibility for report alteration superstar,demcla vent or third puny imerprelation <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 6 of 35 <br />