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Laboratories Inc. � - <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1407872 Page 3 of 4 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.No.15 07/01/13 Page Of <br /> Submission#: 1 _ <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Federal Express ❑ UPS❑ Hand Delivery Ice Chest None ❑ Box p YES ❑ NO ❑ <br /> BC Lab Field Service� Other❑(Specify) Other ❑(Specify) <br /> Refrigerant: Ice Blue Ice ❑ None❑ Other❑ Comments: <br /> Custody Seals Ice}Ches#�, j' Contain�rsr❑ Non Comments: <br /> All samples received? Ye No❑ All samples containers intact? Ye o❑ Description(s)match COC? s o ❑ <br /> f221 S <br /> COC Received Emissivity: O•�J Container: P6- _ Thermometer ID: 2 07 Date/Time r f•$•l�l <br /> tYES El NO Temperature: (A) 2 °C / (C ) ! °C Analyst Init <br /> • SAMPLE NUMBERS - t. <br /> SAMPLE CONTAINERS <br /> 2 3 4 5 '6 7 D' <br /> T GENERAL MINERAL/GENERAL <br /> PTPEUNPRESERVED % <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CflEMI Q4.METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2oz.NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> PIA PHENOLICS <br /> 40ml VOA VIAL TRAVEL BLANK <br /> 40m]VOA VIAL <br /> T EPA 413.1 413.2 418.1 <br /> PT ODOR / <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> T EPA 508/608/8080 <br /> T EPA S15.1/8150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANEC <br /> 100m]EPA 547 <br /> i <br /> 100ml EPA 531.1 <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 8015M <br /> TAMBER <br /> 8 OZ.JAR <br /> 32 0Z.JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG ' <br /> FERROUSIRON <br /> ENCORE <br /> SMART KIT <br /> Summa Canister <br /> Comments: i <br /> Sample Numbering Completed By:_ ✓j/ 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 /> Report ID: 1000229857 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 5 of 30 <br />