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Laboratories Inc. ��i�- <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1307237 Page 4 of 6 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.No.13 08117112 Page a Of <br /> Submission #t: ['22 a3� <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express ❑ UPS❑ Hand Delivery ❑ Ice Chest 01 None ❑ <br /> BC Lab Field Servce Other❑ (Specify) Box ❑ Other El (Specifyl <br /> i <br /> Refrigerant: Ice Blue Ice❑ None)_❑ Other❑ Comments: <br /> Custody Sealslee Chesf❑ _ Conaiiters _None ._ Comments:_. <br /> All samples received? Yes No❑ All samples containers intact? Yes(� No❑ Description(s)match COC? YCO No ❑ <br /> COC Received Emissivity: O�9S Container: Thermometer ID: all l Date/Time <br /> _ � also <br /> YES ❑ NO <br /> Temperature: I Aa °C r (C -� \ °c Analyst Init�� <br /> ) <br /> SAMPLE-NUMBERS <br /> SAMPLE CONTAINERS - 4 s - e 7 a a 10 <br /> t 2 3 <br /> OT GENERAL NERAL/GENERAL PHYSICAL <br /> MI <br /> PT PEUNPRESERVED,. <br /> TIMOR&ANiC.CHEWCAL TAL5 <br /> ..,..,sr�pp�rte� S e �j '�J 0 2 <br /> PT INORGANIC:GIIEMICA,N ETALS <br /> _76"is <br /> PT f6TAL:SULFiDE..... <br /> 2oz NITRATE J NITRTPE. .. <br /> PT TOTAL ORGAPTIC VAI WON <br /> PT TOR <br /> PT.OEDUCAL OXYGEN DEMAND <br /> PtA PHENOLICS.. <br /> 40ro1 VOA:VIAL TRAVEL BLANK <br /> 40m1 VOA VIAL � <br /> EBA.413.]A13.2-_418.1 <br /> Vr ODOR <br /> jibkDIOLOGICAL- -- - _ <br /> BACTERIOLOGICAL .- <br /> 40 rn1 VOA VJAL. 04 - <br /> T EPA 508/608/8080: - <br /> --__..._.. -- <br /> TEPA 515 IB150. ' <br /> T.EPA 525. <br /> T EPA 525.TRAVEL BLANK <br /> 100m)EPA 547 <br /> 100W EPA 531.1 <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 8015M <br /> T AMBER - - <br /> 8 OZ.JAR _ <br /> 32 OZ.JAR -- <br /> SOIL SLEEVE - <br /> PCB VIAL <br /> PLASTIC BAG <br /> FERROUSIRON <br /> ENCORE <br /> 50•LAlil-IiJ r <br /> Comments' <br /> Sar`(Ipp Nurnbe,iny Completed By: sj� Date/Time: <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 6 of 32 <br />