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C7 <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1717171 Paae 2 of 2 <br />:. <br />081#1 <br />Z I W 291 :JITj <br />elm <br />INFORMATIONSHIPPING <br />FOCI M U UPS 0 Ontrac 0 Hand Debery 0 <br />13C Lab Field Service lK Other 0 (Specify) <br />• <br />Ice Chest 12 None 0 Box 0 <br />YES 13 NO (3 <br />Refrigerant: Ice fff Blue fee 0 —None 0 <br />Other 0 Comments: <br />i� <br />CustodyY <br />.: ■ ■yet, <br />m u <br />None 19 Comments: <br />I. <br />AD samples received? Yes No E3 AD samples <br />_ <br />COC . <br />6< YES 0 NO <br />, <br />uiI& <br />�• =iiaply■ �, <br />- 1, _ : :• .-.! <br />��iaaaaaaaiaaa�i <br />R. <br />{rte <br />r.:W-��������� <br />f <br />The results in this report apply to the samples analyzed in accordance with the chain ojcustody document This analytical report must be reproduced in its entirety. <br />All results Gated 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: 1000620713 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />