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Laboratories Inc. iu <br /> ® Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Foran for 1717162 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R CEIPT FORM PaeaUID <br /> Submission#• " M �.P'Z- <br /> SHIPPING INFORMATION SHIPPING CONTAINER F <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest M None ❑ Box ❑ YE <br /> BC Lab Field Service lK Other❑(Specify) Other ❑(Specify) <br /> Refrigerant Ice NP Blue foe❑ None❑ Other❑ Comments: <br /> Custody Seafs •`t ¢ t tteYs;q None 19 Comments: <br /> �1C1� <br /> AB samples received? Yes No❑ A8 samples containers intact? Yes No❑ Desoription(s)match COC? YeCOC Received Emissivity: < Container: � Thermometer ID:� DateITkne <br /> ®YES 0 N T arature: A) -C / (C.) °C` Init <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 7 2 2 4 8 8 8 p <br /> OT <br /> PR UNPRBS <br /> 4as/Sas/16m P&UNPRES <br /> 2azCr Cit JTl. <br /> RGANIC C CAL S4BTALS 1 - <br /> II10 CCE[ CALMRTALS4A-:,., <br /> PT CYANID <br /> PT NUROGEN FORM <br /> PT JOTAL KLMDE <br /> lac NITRAATR <br /> PT TOTAL ORGANI <br /> PrCMUCALOXYGENDSKAND e <br /> PIA PBRNOLICS <br /> VOA VIALTRAVRLRI.ANK <br /> 48ml VOA VIAL <br /> RPA 1 <br /> PrODOR <br /> RADIOLO <br /> BACTRRI02AGICAL <br /> 40 ml VOA VI4I.504 <br /> OT EPA sovemso <br /> OT BASIS RL" '. <br /> OT BPA 525 <br /> OT BPA 525 TRAVEL BLANK <br /> 48m1 RPA 541 <br /> 40M RPA 53L1 <br /> Sos RPA 548 I <br /> BPA Sof <br /> Qj RPA 8015H <br /> EPA WO <br /> 8os/16pz/32as AMMER <br /> Boz/16m1 = <br /> SOILRAM <br /> PGB VL1L <br /> PLASTIC BAG <br /> TEDLA BAG <br /> FERROUS MON <br /> ENCORE <br /> SMART KIT <br /> SUA4MA CANIS= <br /> ;Ommems• <br /> ;ample Nutstbering Completed BY: Date/Time: RW 21 05/23=6 <br /> \=Actual / C=Corrected # 184VAOmrSodP4ffedRAILDOCSMRMUSAMPAECm2Cj <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 parry.BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1000620662 4100 Atlas Court Bakersfield,CA 93308 (661)3274911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />