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El <br />• <br />Laboratories, Inc. <br />Environmental Testing Laboratory Since 1949 <br />t,naln OT L U51ooy ano w.00ier KeCelPT rorm Tor l tzov42 rage L OT 2 <br />BC LABORATORIES INC. <br />COOLER RECEIPT FORM <br />Page <br />Of <br />Submission #: ' <br />SHIPPING INFORMATION <br />SHIVNG CONTAINER <br />FREE LIQUID <br />Fed Ex ❑ UPS E3Ontrac <br />BC Lab Field Service X <br />❑ Hand Delivery ❑ <br />Other ❑ (Specify) <br />Ice Chest None I] Box ❑ <br />Other <br />Y <br />NO ❑ <br />(Specify) <br />W S <br />Refrigerant: Ice <br />Blue ice ❑ None O Other ❑ Comments: <br />Custody Seals `fit', <br />{y.iptjt eis.:j, None Comments: <br />1.tn <br />J :l. <br />AU samples received? Yes <br />No 0 All samples containers intact? Yes No ❑ Dascriptton(s) match COC? Ye%,— <br />COC Received <br />Emissivity: Container. — Thermometer ID: <br />Datafrime <br />WYES ❑ NO <br />— - r^ i _ <br />SAMPLE CONTAINERS <br />rlt,..rylcl.. wrinmove <br />SAMPLE NUMBERS <br />Sample Numbering Completed Sy <br />A = Actual / C = Contacted <br />aw 21 0sn9/01e <br />arom Msuaneu•• 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 submininA part'. BC Laboratories, Inc. assumes no responsibility for report alteration, separation, detachment or third party interpretation. <br />Report ID: 1000655425 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 4 of 12 <br />