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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1209283 Page 2 of 4 <br /> BC-LABORATORIES INC. SAMPLE RECEIPT FORM Rev"No.12 06/24/08 Page-L Of <br /> Submission I-Zc)0-tZ <br /> SHIPPING INFORMATION SHIPPING,CONTAINER <br /> Federal Express ❑ �,UtPS❑ Hand Delivery ❑ Ice Chest[ None ❑ <br /> SC Lab Field Service W Other❑(Specify) Box ❑ Other ❑(Specify) <br /> Refrigerant: Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals:Ice Chest 0 Nonel( .Comments: <br /> Intact?�Yes.D No Intact?Yes.❑ No ❑ <br /> Ali samples received? Yes No❑ All samples containers intact? Ye No O f Description(s)match COC? YeyJ52 No ❑ <br /> COC Received Emissivity: Q•�J Container. Thermometer ID: Daternme 5-21-12•- <br /> *YES ❑ NO 213Lp <br /> Temperature:A C 1 S °C Analyst Init <br /> SAMPLE CONTAINERS 2 3 4 5 s 1 7 e s 10 <br /> QT GENERAL MINERAU GENERAL PHYSICAL <br /> PT PE UNPRESERVED C <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CHEMICAL METALS 17) <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2—NITRATE/MTRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> PtA PHENOLICS - <br /> 40m1 VOA VIAL TRAVEL BLANK - <br /> 40m1 VOA VIAL 1 I 1 1 <br /> T EPA 413.1 413.2 418.1 <br /> PTODOR. -. ..... _.. _.. ._.... _ .. _. _ :.. --- .....__. .. . .. ....... - .. ..... _. .. .. <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VLA1,504 <br /> T EPA 508/6088080 <br /> T EPA 515.1/8150 t ' <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 100-1 EPA 547 <br /> 100-1 EPA 531.1 <br /> -Q!-EP A 548 <br /> T EPA 549 <br /> T EPA 632 <br /> LQT EPA 8015M <br /> QT AMBER <br /> 8 OZ JAR <br /> 32 07-JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> FERROUS IRON <br /> ENCORE <br /> :omments: <br /> sample Numbering Completed By: DatelTme:IS �35' <br /> k=Actual / C=Corrected pl:loocstwranu.Aa_DDc51FORMS15AMREC7.WPDI <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 entirely. <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.bciabs.com Page 4 of 70 <br />