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Man, id <br /> ManLaboratories Inc. <br /> • Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717194 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R CEIPT FORM Pas==L=Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest!d None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service iK Other 0(Specify) Other ❑(Specify) W S <br /> Refrigerant: Ice N( Blue foe❑ None❑ Other❑ Comments: <br /> Custody Seals � tb .>lfiiers:q. None ffi Commence: <br /> AB samples received? Yes No❑ AN samples containers Imact? Yes 0 No❑ Descriptionls)match COC? Yesjd No ❑ <br /> COC Received Emissivity: o Container, Thermometer ID-.24— Datemme <br /> ®YES ❑NO Tsm erature: A) .� •C / C •C r Analyst Ink <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> a a 4 s a 7 a s W <br /> PR uNPRES <br /> 4oz/8aa/160Z PELBVPRES <br /> 2oz Cr" <br /> oTiNoiGANlcciiwcALMxrAEs <br /> INORGANRCCBEML ALS4ozl8az/16as <br /> PT CYANIDE F-U <br /> PT NITROGENi FORMS <br /> PTTOTAL St1LME <br /> 2m hTMTZ INrrRPTB <br /> PT TOT&L ORGANIC QRSON ' <br /> PT CRIMCAL OXYGM DBMAM <br /> PIA CS <br /> 40ml V0A VIAL TRAVEL BLANK . <br /> 40m1 VOA VIAL <br /> T EPA 1664 <br /> PT ODOR <br /> RADIOLOGICAL <br /> B GICAL <br /> 40 ml VO4k VIAL 504 <br /> OT EPA 50&/60818080 <br /> EPA SILIMM t <br /> EPA 525 <br /> QT EPA S25 TRAVEL BLAM <br /> 40mIEPA SO <br /> 48mt EPA 53LI <br /> gas EPA 548 t <br /> EPA 549 <br /> T EPA 80 <br /> OT EPA 8270 <br /> Boz 1 /32oz AMBER <br /> 3as/16aa:lMu AR <br /> SoiL amVE <br /> PCB VIAL <br /> PLAS IC BAG <br /> TEDLARBAG <br /> VMWUSIRON <br /> ENCORE <br /> SMART HIT <br /> SVhWA CANISTER <br /> Iomments: <br /> ;ample Numbering Completed By: Datelllme: - Rev 21 06/2212016 <br /> 1-Actual / C-Corrected tsawroe<t lel <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: 1000620836 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />