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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717193 Page 2 of 2 <br /> pa—pl- <br /> ATORIES INC. COOLER R EIPT FORM Pa Of <br /> on#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> UPS❑ Otttrac❑ Hand Delivery O fee Chest® None O Box ❑ YES ❑ NO O <br /> Reid Ser vice �l Other❑(Spec)fy) Other O(Specify) W S <br /> t Ice Blue ice❑ None❑ Other❑ Comments: <br /> eals Sia'; �: "' :gtillleYs( None BI Comments: <br /> Allreceived? Yes No O As samples containers boat? Yes No❑ Description(s)match COC? YesNo ❑ <br /> COC Received Ens ehrity: CoMalner: - Tnermomaeer ID:2QS paftfn1e (� <br /> r40Z,P,'.7/1Z6DZ <br /> ❑NO T reture: A •C / C. •C, Ana Intt <br /> . sA0@Pi.E NuaastiFts <br /> $ <br /> MPi.E CONTAINERS <br /> a 4 a 7 a w <br /> ZUMMW <br /> los Cr" <br /> OT INORGANIC CB=CALMETALS �- _.___... . _-- <br /> II4 PQMC C"bWALS400/80s/16as <br /> PT AND1B L)B-- Iff n I <br /> PrIgrRoGENFORM ----- <br /> PT TOTAL SULFIDE <br /> 2MNrTRAT91NrrR= <br /> PTTOTALO CCARBON <br /> ® PT CAL07:YGffi4DBMAND e <br /> RAPEINNOLICS <br /> 14W VOA VIALTRAVZL BLANK <br /> 40mt VOA V" WOF <br /> OPT BPA 1664 <br /> ODOR <br /> RADIO <br /> BACTERIOLOGICAL <br /> 40 nd VOA VIAL-504 <br /> OT BPA SOWNW80 <br /> OT BPA SiS.1B150 t <br /> 21 EPA S25 <br /> QTXPA52STUVELIJIAW <br /> 40ml BPA$47 <br /> 48mlEPA53L1 <br /> F1'A S48 t <br /> T RPA SO <br /> OT EPA 801 <br /> OT BPA 8270 <br /> Saallfg/32at AMBER <br /> #ox1U=l32njAR <br /> SOIL BLZM <br /> PCB VIAL <br /> PLASTICRAG <br /> TEDLARRAG <br /> FERRO IRON <br /> ENCORE <br /> SMART EAT <br /> isum"CANISTER <br /> 2omments: <br /> 'ample Numbering Completed By: Date rima: Rev 21 0u2312ot6 <br /> i=Actual / C –Corrected 0lgdWPD*dWa"WftM-DDCMFONAMMNMCm2DI <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 fisted 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: 1000620835 4100 Atlas Court Bakersfield,CA 93308 (661)3274911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />