Laserfiche WebLink
Laboratories Inc. <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1301612 Page 3 of 3 <br />® <br />n <br />COOLER REC EIY I FORM Rev, rdo_ 13 08717112 raye -.L yr <br />BC LABORATOR{ES INC. <br />Submission ?!: `�f/ OZ <br />SHIPPING CONTAINER <br />SHIPPING INFORMATION <br />Hand Deliver ❑ <br />Federal Express Y ❑ PS ❑ <br />ice Chest None ❑ <br />Other ❑ (SpeCiY) <br />BC Lab Field Service Other ❑ (Specify) <br />Box ❑ <br />Refrigerant: ice Wr Blue Ice ❑ None ❑ <br />Other ❑ Comments: <br />Custody Seals Ice Chest ❑ Containers ❑ <br />None t11j,-7Comments: <br />7 �./-) All samples containers intact? Ye --,p No ❑ Deseriptionlsl match COC? Yes No ❑ <br />All samples received. Yes T>Y NOD P <br />Errssivity: <br />r� <br />Container: Thermometer to- Q� DatelTi meoo <br />-a� 3-1�qq- <br />COC Received <br />IL-= <br />-1 <br />v� <br />( YES 0 NO <br />pp3 {{ oAnal stfrillit S7`1U� <br />i C y i <br />Temperature: (A l <br />O C I I C I <br />SAMPLE NUMBERS <br />SAMPLE CONTAINERS t I <br />3 4 5 7 8 5 t0 <br />OT GENERAL MINERALI GENERAL PHYSICA L <br />p <br />PE UNPRESERVED D ()•Z <br />T INORGANIC CHEMICAL METALS <br />r•r• INORGANIC CJMWCAL N9,7A3.S <br />PI• CYANIDE <br />F <br />PT NITROGEN FORMS <br />�= <br />P1- TOTAL SULFIDE <br />Zoz.`+ ITRATE I WRITE <br />P17 TOTAL ORGANIC CARDON <br />PT TOX <br />PT LimmICAL OXYGEN DEMAND <br />PLA PIIENOUCS <br />40m1 VOA VIAL TRA VEL DLANIC <br />t t i i <br />i t <br />i t t t t t t t r <br />40mI VOA VIAL <br />T EPA 413.1 411L 418.I <br />PT ODOR <br />ILAD30LOG3CAL <br />- <br />BACIEMOLOGICAL <br />40 ml VOA V IAL 504 <br />T EPA 508/66818080' <br />T EPA 515.18150 <br />T EPA 523 <br />T EPA Z5 TRAVEL PLANK <br />IOOtni FJ'A 547 <br />306.1 EIIA 531-1 <br />T EPA 548 <br />T EPA 549 <br />T EPA 632 <br />T EPA 8O MI <br />T AA18£R <br />6 OZ JAR <br />32 OZ JAR <br />SOILSLEEVE <br />PCB VIAL <br />PLASTIC RAG <br />FERROUS IRON <br />'- <br />ENCORE <br />SMART 1CIT <br />Comments: <br />,C <br />-Anna: <br />Dcte/Trm=: — Q <br />A = ! = Correrice <br />rsam'oorstworol�+ectuno oor✓' <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 />4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 5 of 40 <br />