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Laboratories, Inc. <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1401576 Page 2 of 2 <br />I LABORATORIES <br />R A <br />BC LABORATORIES INC. COOLER RECEIPT FORM Rev. No. 15 07/01113 Page L of L <br />MB <br />i0 <br />u 6 S! 0 <br />Submission <br />r <br />Submission #: 14 - m5lu <br />I I <br />SHIPPING INFORMATION SHIPPING CONTAINER <br />Federal Express 0 UPS 0 Hand Defivery Ice ChestW None 0 Box EI <br />p <br />BC L. x <br />Lab Feld <br />BC Lab Field Servioex Other 11 (Specify)_ Other [I (Specify)_ <br />krFede,a E <br />FREE LIQUID <br />YES 0 NO D <br />afrigra t. <br />n <br />Refrigerant: <br />Refrigerant: Icefil" Blue Ice 11 None 0 Other 0 Comments: <br />Custody Seals <br />Custody <br />y S <br />Non Comments: <br />H "ample. or <br />.9hred? Yes pNoa All samples containers Intact? Y!�e No 11 Description(s) match COW Yes No 0 <br />P -1 -- <br />COC Received Emissivity: 0Z.,75' Container: t-1- ThermometerID: 20-7 jD.t.M.e1-V-1q- <br />,pr'VES D NO Temperature: Ic C Analyst Inst <br />I <br />I SAMPLE NUMBERS <br />SAMPLE CONTAINERS <br />1 2 3 4 6 6 1 7 1 8 9 110 <br />146PE <br />OTGENERAL GENERAL <br />UNPRESERVED 4�� (7� <br />OT INORGANIC CHENUCAL METALS <br />PTDIORGANIC CH)MUCAL METALS <br />PT NIDE <br />FrNITROGEN FORMS <br />PT TOTAL SULFIDE <br />2-oL NITRATE /NITRITE <br />PT TOTAL ORGANIC CARBON <br />FrTox <br />Pr CHEPMCAL OXYGEN DEMAND <br />PtAPRENOUCS <br />40md VOA VIAL TRAVEL BLANK <br />40m1 VOA VIAL, <br />OT EPA 413.2,41341, 418.1 <br />PT ODOR <br />RADIOLOGICAL <br />BACTERIOLOGICAL <br />40 pal VOA VUL- 504 <br />TEPA 508160MOBO <br />OT EPA 515.118150 <br />QT EPA 525 <br />OT EPA 525 TRAVEL BLANK <br />100ml EPA 547 <br />100mlEPA S31.1 <br />EPA 548 <br />!OTEPA632 <br />t <br />OTEPA801SM <br />ffTAMBER <br />8 07. JAR <br />32 M Ut <br />SOIL SLEEVE <br />PCBVIAL <br />PLASnCBAG <br />FERROUSUON <br />ENCORE <br />SKAETKFT <br />Sitinina Canister <br />*omments: <br />;amole Numberina Completed av: DateMme: -I tv— u uov <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 />4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bc[abs.com <br />Page 4 of 17 <br />MINERAL <br />TEPA 549 <br />