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Laboratories Inc. _ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1718317 Page 4 of 4 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Page —Of <br /> Submission#: ' I" <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest None ❑ Box ❑ YE NO ❑ <br /> BC Lab Field Service Other❑(Specify) Other (Specify) S <br /> Refrigerant: Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals !ce Cliest❑ Containers None Comments: <br /> All samples received? Y4 No❑ All samples containers intact? Yes No❑ Description(s)match COC? Yes)i9.22 No ❑ <br /> — <br /> COC Received Emissivity: Container: Thermometer ID: Date/Time / I <br /> �1\ fYES <br /> El Temperature: (A) °C 1 (C 1 1' °C Ana{yst{nit 1 <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 7 2 1 3 4 15 6 7 8 9 10 <br /> T PE UNPRES <br /> 4oz/Soz/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 /> PIA PHENOLICS <br /> 40ml VOA VIAL TRAVEL BLANK <br /> 40ml VOA VIAL <br /> T EPA 1664 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 4D ml VOA VIAL.504 <br /> T EPA 508160818080 <br /> T EPA 5I5.118150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 40m]EPA 547 ' <br /> 40ml EPA 531.1 <br /> 8oz EPA 548 l <br /> T EPA 549 <br /> T EPA 8015M <br /> T EPA 8270 <br /> 80z/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 /> ;omments: <br /> ample Numbering Completed By: Date/Time: Rev 21 05/23/2016 <br /> t = Actual / C= Corrected ts:1v Po- WordPWWtL.4R D0CS1F0RM515AMREC—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 6 of 30 <br />