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Laboratories Inc. . <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1209283 Page 4 of 4 <br /> BC LABORATORIES INC. SAMPLE RECEIPT FORM Rev.No.12 06/24/08 Page�f <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING,CONTAINER <br /> Federal Express ❑ UPS❑ Hand Delivery ❑ Ice Chest None ❑ <br /> BC Lab Field Service Other❑(Specify) Box ❑ Other ❑(Specify) <br /> Refrigerant: Iceg Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals'Ice O Contalneis None Comments: <br /> Intact?-Yes 0 No❑ Intact171, No.❑ <br /> All samples received? Yes No❑ All samples containers intact? Yetr6�'No❑ p Description(s)match COC? Y"-[?No ❑ <br /> /COC Received Emissivity: Da `Container. e— Thermometer ID: DatefTime 5 2i-(Z <br /> ,YES O NO Temperature:A f-R °C ./ C "C Analyst Init�� 213 <br /> SAMPLE CONTAINERS s 3 4 5 s e s tD <br /> QT GENERAL MINERAL]GENERAL PHYSICAL <br /> PT PE UNPRESERVED <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2oz NITRATE I NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> PtA PHENOLICS A;� <br /> 40.1 VOA V W,TRAVEL BLANK <br /> 40.1 VOA VIAL I l ) ) 1 1 ) 1 ) t > I t ) <br /> T EPA 413.1,4131 418.1 <br /> PTODOR. ._ _ .... _.... .. ....... _ ... ... .. <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40.1 VOA VIAL.504 <br /> T EPA 5DB/608/8080 <br /> 4 <br /> T EPA 515.1/8150 ' <br /> _QT_.EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> I OOmI EPA 547 <br /> 100m]EPA 531.1 ' <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 8015M <br /> QTAMBER <br /> 8 OZ JAR <br /> 32 OZ JAR <br /> SOIL SLEEVE <br /> PC8 VIAL <br /> PLASTIC BAC <br /> FERROUS IRON <br /> ENCORE <br /> Comments: <br /> Sample Numbering Completed By )t�z%0 DaterTime• g3S <br /> A=Actual / C=CorrectedIH:tOocsiwps(nLAB_Dc)cmrDRMSISAMRECZWPDJ <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 patty interpretation. <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.briabs.com Page 6 of 70 <br />