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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717151 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R EIPT FORM page I Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ ice Chest® None ❑ Box ❑ YES ❑ NO <br /> BC Lab Field Service CK Other❑(Specify) Other ❑(Specify) W S <br /> Refrigerant: Ice a Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals •�Gf <br /> 6q. None® Comments: <br /> All samples received? Yes No 0 AB somptea contatnera Intact? Yes No 0 Description(s)match COC? Yes No 0 <br /> COC Received Elmisaivity: o Container: Tharmometar lD:.208 Date/Thus (� <br /> ®YES ❑NO To orature: (a .-2— ^c / (C.) ^c Analyst mit <br /> SAMPLE CONTAINERS SAMPLE NUMBERS <br /> 1 2 3 4 a 7 8 1 8 to <br /> QTPBUNPJM <br /> 4oz/BU/160Z PRUNPRES <br /> 2oz Cr" <br /> T CCH&NICALMETALS <br /> IMO Cby <br /> OMICAL 9atl8ozl16ar <br /> Pr CYAMM <br /> PT NrrROGM I+ORMS SUB-OTT C_ <br /> PTTOTALSULFMZ <br /> 2oz.NITRATE/NITRM <br /> PTTOTALORGAMCCUMON <br /> ® CAL O%Y <br /> pu s <br /> PRA CS <br /> 40ad VOA VIAL TRAVEL.SLAMS <br /> 40mlVOA VIAL ACVr <br /> QT EPA 1664 <br /> FrODOR <br /> RADI <br /> A OLOGI <br /> 40 ml V A VIAL-50 <br /> OTEPASK02012 <br /> BPA51L 150 <br /> OT]RPA <br /> OT BPA SES TR46VEL BLANK: <br /> 40mt EPA 547 <br /> 40adEPA53L <br /> Boz EPA S48 i <br /> 8PA 84 <br /> T EPA 8015M <br /> OT VA 8370 <br /> 8u!6oz/32oz AMISBB <br /> 8"/16ezlnozJAR <br /> SOILSMU <br /> M VIAL <br /> PLASTIC BAG <br /> TEDLAR RAG <br /> FFXWUS IRON <br /> ENCDRB <br /> SMART MT <br /> SUM64A CANN= <br /> :ommeMs• <br /> ;ample Numbering Completed By-JAry Date/Tmte: Rev 21 06/23/2016 <br /> ® 1-Actual / C-Corrected a 0 ; _ mt <br /> The results in this report apply to the samples analyzed in accordance with the chain ofcustody 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: 1000620616 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 vwvw.bclabs.com Page 4 of 12 <br />