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Laboratories Inc. JW, <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Foran for 1701610 Page 2 of 2 <br /> B�LAIBIOREATORIEIS INC. COOLER RECEIPT FORM Page Of <br /> = <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest JS( None ❑ Box ❑ Y 'NO ❑ <br /> BC Lab Field Service fiq Other❑(Specify) Other ❑(Specify) {N / S <br /> Refrigerant: Iced, Blue Ice-0 None❑ Other❑ Comments: <br /> Custody Seals '1,661,i"st© s G talr)ersa®� None Comments: <br /> :,,:fir <br /> All samples received? Yes No O All samples containers intact? Yes No❑ Descriptionts)match COC? Yes No ❑ <br /> ` <br /> COC Received Emissivity: 0.9 7— Container: 1 a Thermometer to, 0Daterrime ' d <br /> X YES ❑ 1 Temperature: (L—) -C / (C 1 G' °C Analyst Init <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS 1 2 3 4 5 a 7 8 e 10 <br /> T PE UNPRES <br /> loz/8oz/16oz PEUNPRES <br /> !0z Cel { <br /> )TINORGANIC CHEMICAL METALS I(I( <br /> NORGANIC CHEMIICAL METALS 4oz/Boz/16oz A <br /> : <br /> 'T CYANIDE <br /> 'T NITROGEN FORMS <br /> T TOTAL SULFIDE <br /> V&NITRATE/MTRTTE I <br /> T TOTAL ORGANIC CARBON <br /> i <br /> ® T CE=41CAL OXYGEN DEMAND yy <br /> 1A PHENOLICS I <br /> Oral VOA VIAL TRAVEL BLANK { <br /> ami VOA VIAL <br /> ,T EPA 1664 <br /> T ODOR # <br /> ADIOLOGICAL + <br /> ACTERIOLOGICAL <br /> , <br /> )ail VOA VIAL-SO4 I <br /> T EPA 508/608/8080 <br /> TEPA 515.1/8150 ' <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK i <br /> Ind EPA 5.47 <br /> Ind EPA 531.1 - - <br /> a EPA 548 <br /> T EPA 549 <br /> T EPA 8015M <br /> i <br /> T EPA 8270 <br /> f <br /> 2/16oz/32oz AMBER `! <br /> z/16az/32oz JAR <br /> i <br /> )IL SLEEVE <br /> :B VIAL <br /> .ASTIC BAG <br /> 3DLAR BAG <br /> f <br /> IRROUS IRON <br /> F <br /> QCORE <br /> 4 <br /> 4ART KIT <br /> k <br /> IMMA CANISTER I <br /> I <br /> mments: I <br /> nple Numbering Completed By: Date/Time: ' Rev 21 0512312016 <br /> IS:iWPeodWotdPerfee0LA600LereflMSISAMSELrev 201 <br /> The results in this report apply to the samples analyzed in accordance with the chain ofcustody 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 /> Report ID: 1000565084 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />