Laserfiche WebLink
Environmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1604052 Page 2 of 2 <br />COOLER RECEIPT FORM Page Of <br />BC LABORATORIES INC. <br />Submission #: I (D ^ FREE LIQUID <br />NG CONTAINER <br />SHIPPING INFORMATION YES ❑ NO ❑ <br />Box 13Fed <br />E <br />Ice Chhestest C <br />�yjO None D <br />Ex ❑ UPS ❑ Ontrac ❑ Hand Delivery ❑ Other iSpecifyl <br />BC Lab Field Service NO Other ❑ (Specify) <br />Refrigerant: Ice Blue Ice ❑ None ❑ Other ❑ Comments: <br />❑ None Comm nts: <br />Custody Seals Ice Chest ❑ . / Containers <br />Yes <br />ha—t? <br />No ❑ Description(s) match COC? Yes No D <br />All samples received? Yes Ne ❑ All samples containers intact? Yes y / � I7 <br />ID: Date/Time eG <br />Emissivhy: Container. Thermometer <br />COC Received <br />eC Analyst Wit <br />ES ❑ NO Tem erature• (A) °C / (C ) <br />SAMPLE NUMBERS <br />10 <br />SAMPLE CONTAINERS s g 9 z q <br />� 3 0 <br />T PE UNPRES <br />4oz/Boz/16oz PEUNPRES <br />20Z Cr" <br />T INORGANIC CHEMICAL METALS <br />INORGANIC CHEMICAL METALS 4oz/8oz / 160z <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 />PLA PHENOLICS <br />40m1 VOA VIAL TRAVEL BLANK <br />40m! VOA VIAL - <br />T EPA 1664 <br />PT ODOR <br />RADIOLOGICAL <br />BACTERIOLOGICAL <br />40 nd VOA VIAL- 504 <br />T EPA 5081608/8080 <br />T EPA 515.1/8150 <br />QT EPA 525 <br />T EPA S25 TRAVEL BLANK <br />40m! EPA 547 <br />40m! EPA 531.1 <br />8oz EPA 548 <br />T EPA 549 <br />TEPA 8015M <br />T EPA 8270 <br />Boz / 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 />Rev 20 07/24/2015 <br />cf- < c , <br />Comments:Date/Time - <br />q-1, rdumhnrina Comoleted By w evut onus 0ocstrounstsgmnEca 201 <br />The results in this report apply to the samples analy_ed in accordance widt the chain ojcuslodv document This analytical report must he 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: 1000448686 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 4 of 12 <br />