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MIND <br /> mm� <br /> Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717179 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R FJPT FORM Pe Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest W None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service 19 Other❑(Specify) Other ❑(Specify) W S <br /> Foanvies <br /> : Ice N Blue Ice❑ None❑ Other❑ Comments: <br /> als r6Cibtirs q None Comments: <br /> ANceived? Yes No❑ AO samples containers intact? Yes 0 No❑ Description(s)match COC? yeso No ❑ <br /> COC Received Ernissdvity: d445 Container: .Thermometer ID: _ Date/rkne <br /> ®YES ❑NO Temperature: A ,'i •C I t C.) •C I.Anal Will <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 z a s 7 e s to <br /> OTPRUNPRIS <br /> 4oz/S=/16ez PEWRTIS <br /> 2szCr" �'ls_ { m <br /> C CBBMiCAL MET _ <br /> II40 CCREMI ALS4oz/ 16oz "i - t <br /> PrCYANIDE <br /> PT NrrROGEN IrORMB <br /> PTTOMSULFIDE <br /> 2oz.MTRA7Z/MTRrrX <br /> PI'TorALORGAMCCARSON <br /> PT C1=QkL QMT <br /> PtA PHENOWS <br /> 40md VOA VLiLTRAVEL BLANK <br /> 40M VOA VIAL t <br /> Or Xft 1664 <br /> Fr R <br /> RADI LOCI <br /> BACrZRIOLOGICAL <br /> 40 and VOA VIAL <br /> OT EPA SWIMUM <br /> gj EPA SULMIN <br /> 1sPA 52S <br /> OT A 52S TRAVEL RIANK <br /> 40md EPA 597 <br /> 40md EPA 53L1 <br /> Boz EPA 548 d <br /> gj EPA S49 <br /> T BPA SOMM <br /> OT EPA 8270 <br /> Boz/16oz 137m AMBER <br /> Sms/I z/32crAR <br /> SOIL <br /> VIAL <br /> PLASTIC BAG <br /> TEDLAR$AG <br /> PERROIIS IRON <br /> IMCORE <br /> SMART ar <br /> SUMMA CANISTER <br /> Somments• <br /> :ample Numbering Completed By: catelTlme: R.zt OWZWmte <br /> 0 e=Actual 1 C=Corrected tmisw®.mw=areExcrRae_ est <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 /> Allresults listed in this report are for the exclusive use of the submininp party.BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1000620770 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />