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Laboratories Inc. _ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1307237 Page 3 of 6 <br /> 1C LABORATORIES INC. COOLER RECEIPT FORM Hev.No.13 08/17112 Page l Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> ederal Express ❑ UPS❑ Hand Delivery El lee Chest 1�1 None 1-13C Lab Field Service Cy Other❑(Specify) Box ❑ Other ❑ (Specify) <br /> '' NOn8;0 Other❑ COmmplats: <br /> Refngerani: Ice Blue Ice ❑ <br /> -ustody Seals =t❑ _ Containers❑ ___None Co�Lmerzts.:_..____ —_ - -- - <br /> 411 samples received? Yes No o❑ All samples-containers intact? Yes No❑ Description(s)match COC? Yes No ❑ <br /> COC Received Emissivity: qs Container: Thermometer ID: DatelTime <br /> YES ❑ NO °C ( (C ) OrS °.0 Analyst Init JQQ_gISD <br /> Temperature: (A) C <br /> SAMPLE NUMEtERS <br /> SAMPLE CONTAINERSe 7 a 9 to <br /> t 2 3 9 5 <br /> OT GENERAL MINERAL/GENERAL PHYSICAL <br /> PT PE UNPRESERVED_.. . <br /> TINORGANIQ.d#E113��)cC'AL�MpE <br /> PT 1NORGAN1.CrCHEMICALl1'ICTALS <br /> PT-CYANIDE <br /> PTN1TIEd.GF.NFORMS <br /> PT TOTAI SULFM <br /> 2oz NITRATE!Nl'1'R1T1S <br /> PT TOTAL ORGAM- C•CARBON <br /> PT TOR <br /> PT CEInUCAL OXYGENDEMAND <br /> AA-PE>ENOLICS...- - <br /> 40.1 VOA VUL TRAVEL BLANK <br /> 40.1 V oA YIAi. <br /> T EPA 413.1 413.2.418.1 <br /> PT ODOR <br /> RADIOLOGICAl... <br /> �BACTERIOLOGIGAL <br /> 40 ml VOA:VI$1.-504. ' <br /> T EPA 5081608A680- - <br /> T EPA 315.1!8150 <br /> T.EPA.525. . <br /> TEPA 325 TRAVEL BLANK <br /> 1001W EPA 547 <br /> 100m1 EPA 531.1 <br /> T EPA 548 <br /> T EPA 349 <br /> TEPA 632 <br /> T EPA 8015M <br /> T AMBER <br /> 8 OZ.1AR <br /> 32 02.JAR <br /> SOIL SLEEVE <br /> PCB VIAL. <br /> PLASTIC BAG <br /> FERROUS IRON <br /> ENCORE <br /> sn•I_vn'IaT <br /> Comments: �( •3S <br /> Sample Numbering Cumpleled By: JIJ Date/Time: L <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 /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 5 of 32 <br />