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r� <br />d <br />[1 <br />r, <br />0 <br />E <br />r� <br />Laborato�aes, Inc. IaLkU <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custodv and Cooler Receint Form for 1401575 Paae 2 of 2 <br />BC LABORATORIES INC. COOLER RECEIPT FORM Rev. No. 15 07101113 Page _J__ Of <br />Submission #• <br />SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br />Federal Express ❑ UPS ❑ Hand Delivery ice Chestpo' None ❑ Box ❑ YES ❑ NO ❑ <br />BC Lab Field Service Other ❑ (Specify) Other ❑ (Specify) <br />Refrigerant: Ice Blue Ice ❑ None ❑ -Other ❑ Comments:. <br />Custody Seals lce Chest OJ <br />Cont�inersO NonComments: <br />t _ri <br />All samples received? Yes'V No ❑ ' All samples containers intact? YosrR No ❑ Description(s) match COC? Yesp No ❑ <br />COC Received <br />OA(ES❑ iV0 <br />Emissivity: .2 Container: PC ThermometeriD: 9Z7 <br />Temperature: 1 A)--D—.i—.0 / (C ) °C <br />Datemme/2% <br />Anal Init <br />Y <br />SAMPLE NUMBERS <br />SAMPLE CONTAINERS <br />1 2 3 4 6 6 7 B 9 to <br />T GENERA"GENERAL <br />N,fPF UNPRESERVED <br />T INORGANIC CHEMICAL METALS <br />PT INORGANIC CHEMICAL METALS <br />PT CYANIDE <br />PT NITROGEN FORMS <br />PT TOTAL SULFIDE <br />2oz.N1TRATE /NITRITE <br />PT TOTAL ORGANIC CARBON <br />PTTOx <br />PT CHEMICAL OSYGEN DEMAND <br />PIA PHENOLICS <br />40ta! VOA VIALTRAVELBLAM <br />40m] VOA VIAL t t t t t t o t t t t t t t t t t l t 1 <br />T EPA 413.1,4= 4181 <br />PT ODOR <br />RADIOLOGICAL <br />BACTERIOLOGICAL <br />40 ml VOA VLSL 504 <br />OT EPA 508/6088080 <br />T EPA S15181S0 <br />EPA 52S <br />T EPA 525 TRAVEL BLANK <br />100m1 EPA S47 <br />Ieand EPA 531.1 <br />T EPA 548 <br />OT EPA 549 <br />OT EPA 632 <br />OT EPA 801SM <br />AMBER <br />8 07. JAR <br />3202. JAR <br />SOIL SLEEVE <br />PCB VIAL <br />PLASTICBAG <br />FERROUS IRON <br />ENCORE <br />SMART KIT <br />Summa Canister <br />Comments: <br />Sample Numbering Completed By: Date/Time: - <br />• _.......,.•,.•.......__..._.r--.0 n°nnn<.enoMcrcEMPEMFI <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.bclabs.com Page 4 of 39 <br />