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Laboratories Inc. <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1601579 Page 2 of 2 <br />The results in this report apply to the samples analv_ed in accordance with the chain of custodv 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 parry interpretation. <br />Report ID: 1000443223 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 4 of 21 <br />BC LABORATORIES INC. <br />COOLER RECEIPT FORM <br />Page Of <br />Submission #• <br />SHIPPING INFORMATION <br />Fed Ex ❑ UPS ❑ Ontrac ❑ Hand Delivery ❑ <br />BC Lab Field Service Other ❑ (Specify) <br />CONTAINER <br />SHIPPJ <br />Ice Chest None ❑ Box ❑ <br />Other (Specify) <br />FREE LIQUID <br />11NG <br />YES NO ❑ <br />Refrigerant: lce Blue Ice ❑ None ❑ <br />Other ❑ <br />Comments: <br />Custody Seals <br />1 ..Chest <br />Containers ❑ " <br />None <br />Comments: <br />All samples received? Yes No ❑ All samples containers intact? Yes No ❑ Desedpition(s) match COC? Yes o ❑ <br />OC Received <br />YES ❑ NO <br />Emissivity: d •97 <br />Tem erature: (A) <br />Container: <br />/ <br />'(r" Thermometer ID: IPZ Dat.mme / I o23j J <br />-C / (C) Q; "C Analyst snit <br />SAMPLE CONTAINERS <br />1 2 <br />3 <br />` SAMPLE NUMBERS <br />4 6 1 8 7 <br />6 e 70 <br />T PE UNPRES <br />4oz/Soz/16oz FEUNPRES <br />2oz CrK <br />T INORGANIC CHEMICAL METALS <br />INORGANIC CHEMICAL METALS 4oz / Roz / 16oz <br />PT CYANIDE <br />PT NITROGEN FORMS <br />PT TOTAL SULFIDE <br />29L NITRATE/NITRITE <br />?T TOTAL ORGANIC CARBON <br />?r CHEMICAL OXYGEN DEMAND <br />4A PIDINOLICS <br />" <br />IOmI VOAYIAL TRAVELBLANK <br />;Oail VOA VIAL <br />IT EPA 1664 <br />TODOR <br />:ADIOLOGICAL <br />ACTERIOLOGICAL <br />D nil VOA VIAL -504 <br />T EPA 508/6084080 <br />T EPA SI5.118150 <br />T EPA $25 <br />T EPA 525 TRAVEL BLANK <br />mil EPA 547 <br />ml EPA 53LI <br />z EPA 548 <br />r EPA 549 <br />r EPA SOISM <br />CEPA 8270 <br />i/16oz/32oz AMBER <br />:/16oz / 32oz JAR <br />IL SLEEVE <br />B VIAL <br />ASTIC BAG <br />DLAR BAG <br />RROUSIRON <br />CORE <br />ART KIT <br />IFMA CANISTER <br />ments: <br />Pie Numbering Completed By: <br />Actual / C = Corrected <br />DateMme: Rev 20 07/24/2015 <br />IsdwPoe.Awe.dPoteeatne oocsvoaysteAMaeCI-tot <br />The results in this report apply to the samples analv_ed in accordance with the chain of custodv 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 parry interpretation. <br />Report ID: 1000443223 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 4 of 21 <br />