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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> ® Chain of Custody and Cooler Receipt Form for 1717166 Page 2 of 2 <br /> Be LABORATORIES INC. COOLER r-IPT FORM Pae Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex O UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest 8 None O Box ❑ YES ❑ NO O <br /> BC Lob Field Service IK Other❑(Specify) Other ❑(Specify) W S <br /> Refrigerant: Ice Iff Blue Ice❑ None O Other❑ Comments: <br /> Custody Seals t[a 0 r >41i+ets q. None 19 Comments: <br /> Ad samples received? Yes No O All samples containers intact? Yes No❑ Desoriptkm(s)match COC? y"jil No ❑ <br /> COC Received Emissivity: . coMainar:_ _ Thermometer ID:209 Datefrims, (� <br /> ®YES ❑NO r sure: A ,3, •C / (C.) •c An kat <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> t 2 3 4 a 6 7 g g p <br /> PEXWRES <br /> 4ox/Sox11�PEEINPRSS <br /> lox cel <br /> T ANICC68tKICALMETALS <br /> IBU <br /> tNORGANICCB88Si lMETALS4oz/box/16. <br /> PT CY E <br /> IT <br /> PT NITROGEN FORMS <br /> Fr ALSULF7DE <br /> 2L NTPRATE/NITRITE <br /> PT AL ORG C CARBON <br /> PT CAL OXYGENDWAND <br /> ® PIALICS <br /> VOA VIAL <br /> V TRAVEL BLANK <br /> 40ml VOA VUL <br /> EPA 1660 <br /> PT ODOR <br /> RADIOLOGICAI <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-SO4 <br /> EPA 50&608/8080 <br /> EPASH.LSISO "t <br /> >PAMS <br /> GrEPASISTRAVELDLAW <br /> 40ml EPA 567 <br /> 40ml EPA 53L1 <br /> Soz EPA S48 t <br /> OT EPA 549 <br /> OT EPA SOW <br /> OT EPA 5278 <br /> 8CM/16ax32oz AMBER <br /> 8OM1 /32oz AR <br /> S01LXJWZ <br /> PCB VIAL <br /> PLAM BAG <br /> TEDLARBAG <br /> FEV"Us ION <br /> ENCORE <br /> S64ART BST <br /> SLUMA CANISTER <br /> :omments' <br /> ;ample Numbering Completed By: DetetTkrte: aav 27 aw2atzots <br /> 1- Actual 1 C c Corrected tsa noesvoaMsutatxEcm= <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: 1000620695 4100 Atlas Court Bakersfield,CA 93308 (661)3274911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />