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Laboratories Inc. _ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1609747 Page 2 of 3 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Page Of <br /> Submission #t: . <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS ❑ Ontrac❑ Hand Delivery ❑ Ice Chest YJ None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service Other❑(Specify) Other (Specify) <br /> Refrigerant: Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals It T>�?as� None Comments: <br /> All samples received? Yes No O All samples containers intact? Y No❑ Description(s)match COC? Yes No ❑ <br /> COC Received Emissivity: G. Container: VE', Thermometer ID: Date/Timeg-5,40 <br /> Lf'ES ❑ NO Temperature: (A) °C / (C ) °C Analyst[nit <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 7 2 3 4 5 6 7 81 9 10 <br /> T PE UNPRES <br /> 4oz/Soz/16oz PEUNPRES ' <br /> 20z Cr" <br /> T INORGANIC CHEMICAL METALS <br /> INORGANIC CHEMICAL METALS 4oz/So116oz <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2oz.NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYGEN DEMAND ggg <br /> PIA PHENOLICS <br /> 40m1 VOA VIAL TRAVEL BLANK <br /> 40m1 VOA VIAL <br /> T EPA 1664 <br /> PT ODOR <br /> RADIOLOGICAL - <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL.504 <br /> T EPA 508/608/8080 <br /> T EPA 515.1/8150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 40ml EPA 547 <br /> 40ml EPA 531.1 <br /> Soz EPA 548 <br /> T EPA 549 <br /> T EPA 8015M <br /> T EPA 8270 <br /> 80z/160z/32oz AMBER <br /> 8oz/16oz/32oz JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLAR BAG <br /> FERROUS IRON <br /> ENCORE <br /> SMART KIT <br /> SUMMA CANISTER <br /> Comments: <br /> Sample Numbering Completed By: Date/Time: Rev 20 07/24/2015 ' <br /> A = Actual / C = Corrected (SIWPOo XWordPedect\LAB OOCSIFORMSISAMREC.e 201 <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: 1000472380 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 29 <br />