Laserfiche WebLink
Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717173 Page 2 of 2 <br /> BC LABORATOMES INC. COOLER R EIPT FORM Page Of <br /> Submission#• — -1 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest ISI None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service 0 Other❑(Specify) Other ❑(Specify) W I S <br /> Refrigerant Ice fir Blue Ice❑ None❑ Other 0 Comments: <br /> Custody Seals # :t:04 411;ers.- . None IN Comments: <br /> Ail samples received? Yes No❑ All samples containers intent? Yea 0 No❑ Description(s)match COC? Yosjd No ❑ <br /> COC Received Emissivity: a Container: Thermometer ID:2_0 DatenIme t7 <br /> ®YES El NO r erature: A) •c / C. •C An st Ink <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 2 3 4 a 7 B <br /> P8 <br /> 4oa/Bm/M a PBIBP'RBS <br /> 2M Cr" <br /> Qj RMAO&MC CF EMICAL MErALS– <br /> RMRQAMC CEIEWCAL MBTALS /Boa/16oa <br /> PT CYANM <br /> PT FORMS <br /> PTTOTALSULFE3R <br /> 2oa.NrMTR/NITRITB <br /> PTTOTALORcAMCCUMON <br /> PT tHEtICAL OXY DRM'ANA <br /> PIA rimigm <br /> 40mt VOA VIAL T <br /> 40mt VOA VIAL <br /> Qr RPA 1664 <br /> PTODOR r <br /> RAD LOGICAL <br /> BA O I <br /> 40 ml V VIA 504 <br /> OT BPA 30 <br /> )3T S35 &L% <br /> OT A S25 <br /> OT RPA 525 TRAVEL BLANK <br /> 40ml RPA S47 <br /> 40m1RPAS3L1 <br /> Sac RPA sa t <br /> OTRPAS49 <br /> QT RPA WHIA <br /> OT RPA 8270 <br /> Soa/16oa/32aa AMBER <br /> 8oa/16Dx/ AR <br /> SOILSLEEVE <br /> FC13 VIAL <br /> PLASTICBAG <br /> TSDLARBAG <br /> FERROUS MON <br /> ENCORE <br /> BMART Krr <br /> SEMM CANIS= <br /> :ommeMs• <br /> temple Numbering Completed By: Date/Time: Rw 21 OWN201e <br /> t=Actual / C e Corrected IBawro dV4oW6 aceua_ 201 <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 part'.BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1000620715 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />