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Laboratories Inc. _ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1718317 Page 3 of 4 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Page Of <br /> Submission#: [7 (9-3 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest None El ❑ YE NO ❑ <br /> BC Lab Field Service I Other❑(Specify) Other (Specify) / SS <br /> Refrigerant: Ice / Blue Ice ❑ None❑ Other❑ Comments: <br /> Custody Seals Ice Chest❑1 Gontainers❑ None Comments: <br /> All samples received? Yes No❑ All samples containers intact? Yes No❑ Description(s)match COC? Yes y No ❑ 1 <br /> COC Received Emissivity: Container: Y ( Thermometer ID: Date/Time ! <br /> YES ❑ NO Temperature: (A I i °C ! (C I 1' °C Analyst Init '1 <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 2 3 4 6 6 7 8 9 70 <br /> T PE UNPRES <br /> 4oz/8oz/16oz PE UNPRES <br /> 2oz Cr" <br /> T INORGANIC CHEMICAL METALS <br /> INORGANIC CHEMICAL METALS 4oz!8oz!16oz <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 /> PtA PHENOLICS <br /> 40ml VOA VIAL TRAVEL BLANK <br /> 40ml 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 J <br /> 40m1 EPA 531.1 <br /> 8oz EPA 548 / <br /> T EPA 549 <br /> T EPA 8015M <br /> T EPA 8270 <br /> Soz/16oz/32oz AMBER <br /> 8oz/16oz/32oz JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLARBAG <br /> FERROUS IRON <br /> ENCORE <br /> SMART KIT <br /> SUMMA CANISTER <br /> Comments: <br /> Sample Numbering Completed By: I Date/Time: Rev 21 05/23/2016 <br /> A = Actual / C = Corrected is:IWFt oc WofdPerim6LAa DOCSIFORMSISAMREC,,,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 intermetation. <br /> Report ID: 1000625348 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 5 of 30 <br />