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Laboratories Inc. ��i�- <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1708750 Page 4 of 4 <br /> COOLER RECEIPT FORM Page <br /> BC LABORATORIES INC. Z- yr <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest K None ❑ Box ❑ YES NO ❑ <br /> BC Lab Field Service lel Other❑(Specify) Other ❑(Specify) S <br /> Refrigerant: IceV Blue Ice❑ None❑ Other❑ Comments: <br /> None Comments: <br /> Custody Seals e <br /> All samples received? Yes No❑ All samples containers intact? Yes No❑ Description(s)match COC? Yes No ❑ <br /> COC Received Emissivity: Container: Thermometer IM, Date/Time I <br /> $4 YES ❑ NO Temperature: (A) 0, 5 eC / (C ) 0 lS °C Analyst Inst t <br /> SAMPLE NUMBERS <br /> .SAMPLE CONTAINERS 1 z 3 5 6 7 a s to <br /> T PE UNPRES <br /> 4oz/Soz/16oz PE UNPRES <br /> 2oz Cr" <br /> T INORGANIC CHEMICAL METALS <br /> INORGANIC CHEMICAL METALS 4oz/Soz/160z <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 <br /> PIA PHENOLICS <br /> 40ml VOA VIAL TRAVEL BLANK <br /> 40m!VOA VIAL <br /> T EPA 1664 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> QT EPA 508/608/8080 <br /> T EPA 515.118150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 40ml EPA 547 <br /> _ 4QMI EPA 531.1 _.. _.. _. .._.._.._..._......--- -- <br /> 8oz EPA 548 <br /> T EPA 549 <br /> T EPA 8015M <br /> T EPA 8270 <br /> 8oz/16m:/32oz AMBER <br /> 8oz/16oz/3202 JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLARBAG <br /> ._ FERROUS-i964....... ---------_. ....... <br /> ENCORE <br /> - SMARTICLT ............ --....-..... _._..-----.'—._.. ... -- ..._._.. <br /> SUMMA CANISTER - <br /> Comments: <br /> Sample Numbering Completed By: Date/Time: ' nev 21 05123/2016 <br /> is.%WPUodWordPe,fenlLA6 OOCStFORMS%SAMBECrev 261 <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: 1000593760 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 6 of 30 <br />