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ValeLaboratories Inc. <br /> ® Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717148 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R EIPT FORM Page Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Deanery ❑ Ice Chest 0 None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Reid Service It Other❑(Specify) Other ❑(Specify) W S <br /> Refri erant: Ice 9 Blue ice❑ None❑ Other❑ Comments: <br /> Custody Seals ap Vii$ fl i(�ets )•. None 19 Comments: <br /> All samples received? Yes No O A9 samples containers Intact? Yes No 0 Descript�a(s)match COCZ Yea No O <br /> COC Received Emissivity: Container: Thermometer ID:�— Datemme O <br /> ®YES 0 NO To rature: A .,'� °C (C_ °C r Anal Wit <br /> SAMPLE NUMMM <br /> SAMPLE CONTAINERS <br /> 1 2 3 4 8 8 7 8 9 <br /> 4oz/Sm/16oz PRUNPRBS <br /> e <br /> INORGANICQj <br /> CHEMICAL hWrA15 <br /> O C i=METALS4oz! /16oz — I <br /> PT CYANDS <br /> PT ZK RMS <br /> PT AL E 7 T7- - `' <br /> 2oz TR/ <br /> PTTOTALO CCARBO <br /> PT CBffi14[CAL ORYGSND o <br /> PIA PBSNOLICS <br /> 40mIV TRAVBLBLANK <br /> 40nd VOA VIAL <br /> gj SPA 1664 <br /> PT ODOR <br /> I <br /> BACTSRIOLO <br /> 40 mI VOA VIAir <br /> BPA <br /> OTEPARLOW ,.t - <br /> Or SPA 529 <br /> QTZPAnSTRAVEL BLANK <br /> 40ad EPA 547 <br /> 40M EPA 5XI <br /> Boz EPA 548 t <br /> BPA 549 <br /> BPA 11015114 <br /> BPA 8270 <br /> 8m/16oz/32oz AMBER <br /> 8oz116oa/32asAR <br /> SOIL SLEM <br /> PCB VIAL <br /> PLASTIC SAG <br /> TBDLARRAG <br /> FERROUS IRON <br /> ENCORE <br /> SMARTRIT <br /> SUMMA CANN= <br /> :omments: <br /> ® ;ample Numbering Completed By: Date/Thne: Rev 21 05123=6 <br /> 1=Actual / C=Corrected tNWPftdW*WV!(WffiAk00CW0WWXM0Cm2M <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 /> 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: 1000620498 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />