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Laboratories, Inc. <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1724535 Paqe 2 of 2 <br />The results in this report apply to the samples analyzed in accordance with the chain of custody 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 party interpretation. <br />Report ID: 1000646506 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bdabs.com Page 4 of 12 <br />BC LABORATORIES INC. <br />COOLER R CEIPT FORM <br />Page Of <br />Submission #• <br />SHIPPING INFORMATION <br />Fed Ex ❑ UPS ❑ Ontrac ❑ Hand Delivery ❑ <br />BC Lab Field Service Other ❑ (Specify) <br />SHIPPING CONTAINER <br />Ice Chest Z None ❑ Box ❑ <br />Other ❑ (Specify) <br />FREE LIQUID <br />Y NO ❑ <br />rjj(/ S <br />Refrigerant: 1ceX Blue Ice 0 None ❑ <br />Other ❑ Comments: <br />Custody Seals <br />I1eSi%Q:."• <br />Ct%lta�nrs.'R <br />NoneX Comments: <br />41l samples received? Yes No (3 All ...pies containers intact? Yes No O Descriptions) match COC? Ye No O <br />COC Received Emissivity: <br />RYES ❑ NO Temperature: (A) <br />Container: Thermometer ID: -ZoPi Dat eMme <br />-C ! (C ! 0 •L/I"C Analyst Init <br />SAMPLE CONTAINERS <br />1 2 <br />- SAMPLE NUMBERS <br />3 4 5 8 7 <br />8 9 10 <br />T PE VNPRES <br />loz/Soz/16oz PEUNPRES <br />- <br />Cr" <br />T INORGANIC CHEMICAL METALS <br />NORGANIC CHEMICAL METALS 4ozIsoz/16oz <br />'T CYANIDE <br />. <br />'T NITROGEN FORMS <br />'T TOTAL SULFIDE <br />:oz. NITRATE/NITRITE <br />'T TOTAL ORGANIC CARBON <br />' <br />IT CHEMICAL OXYGEN DEMAND <br />'tA PHENOLICS <br />10mI VOA VIAL TRAVEL BLANK <br />IOml VOA VIAL <br />T EPA 1664 <br />'T ODOR <br />3ADIOLOGICAL <br />iACTERIOLOGICAL <br />:0 m1 VOA VIAL -504 <br />T EPA 508!608/8080 <br />T EPA 515.1/8150 <br />TEPA525 <br />T EPA 52S TRAVEL BLANK <br />Oml EPA 547 <br />Oral EPA 531.1 <br />oz EPA 548 <br />T EPA 50 <br />T EPA 8015M <br />- <br />T EPA 8270 <br />oz/16oz/32oz AMBER <br />oz / 16oz I32oz JAR <br />AIL SLEEVE <br />CB VIAL <br />'LASTIC BAG <br />MOLAR BAG <br />'ERROUSIRON <br />:NCORE <br />MART KIT <br />T7MMA. CANISTER <br />tmments• <br />imple Numbering Completed By: <br />= Actual 1 C = Corrected <br />Dateirme: b Rev 21 05/2312016 <br />(s:twv000twordre4eauas DOCSMRM=AMRECiev 201 <br />The results in this report apply to the samples analyzed in accordance with the chain of custody 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 party interpretation. <br />Report ID: 1000646506 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bdabs.com Page 4 of 12 <br />