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Was <br /> saleLaboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717180 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R EIPT FORM Pae Of <br /> Submission#• —1 ' <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 19 Other❑(Specify) .Other ❑(Specify) W / S <br /> Refrigerant. Ice 9 Blue Ice❑ None❑ Other❑ Comments: <br /> Custody ' <4 <br /> Seals ��b•:. WA -.6 None Comments: <br /> I'All samples recalued? Yes No 0 AN samples containers btlaot? Yes No❑ Desodption(s)match COC? YeSA No ❑ <br /> COC Received Emissivity: M5 Container. Thermometer ID:,MS— DateMme Q <br /> IS YES O NO T ure: I A 1 •,� •C C. 'C, AnalM Inh <br /> IL <br /> SAMPLE CONTAINERS SAMPLE NUMBERS <br /> 1 2 S 4 a a 7 a a 10 <br /> PE UNPRBS <br /> 4os/8os116=PRUNPRBS <br /> 2oz Cr" <br /> OT INORGANIC CMUCAL METALS <br /> INORGANIC CBffliCAL METALS Oat/8oz/16oz <br /> PT CYANIDE 5 t 3 x <br /> PT t41TEOGEN FOFMfS <br /> PT TOTAL SULFIDE <br /> 2oz.N1MTS/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PTCHIROCALgOLGENDEMAND <br /> P!A PHEt401I e . <br /> 40miVO&VULM&MBLANK <br /> 40ad V YIAL <br /> RPA 1664 . <br /> PT ODOR <br /> RADIOLOGI <br /> BACTERIOLOGICAL <br /> 40 ad VOA VI4L•504 <br /> OT EPA SIDWAM <br /> OT EPA S15MLW <br /> EPA STS <br /> BPA S25 TRAVEL BLANK <br /> 40a0EPAS47 <br /> 40mlEPAS31.1 <br /> On EPA S48 t <br /> EPA D19 <br /> B'PA SOLW - <br /> gj EP <br /> Sos! /32at AMBER <br /> dos/I /32� AR <br /> VB <br /> PCB VIAL <br /> KAMCBAG <br /> TEDLARBAG <br /> FBRROUS MON _ <br /> ENCORE <br /> SMART sTr <br /> SUMMA CANISTER <br /> :omments• <br /> ample Ntmtbering Completed By: Date/Time: aev 21 Os/2s/zat0 <br /> ® =Actual / C=Corrected tan...." .l 0LAI O000000101SMiRE—aO <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: 1000620771 4100 Atlas Court Bakersfield,CA 93308 (661)3274911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />