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® Laboratories Inc. ljtdi <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1213026 Page 2 of 3 <br /> [EBEICLABORATORIES LNC. SAMPLE RECEIPT FORM Rev,No.12 06124[(311 Page Of <br /> mission #: 3bz'p <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express 0 UPS❑ Hand Delivery ❑ Ice Chest)5 None O <br /> BC Lab Field Service/[]) Other❑(Specify) Box ❑ Other ❑(Specify) <br /> Refrigerant: Ice P3 Blue Ice❑ None 0 Other❑ Comments: <br /> Custody SealsIce Cllest E3on <br /> Ctainers❑ Non Comments: <br /> Intact?Yes 0.No❑ irilact7'Xes O No O <br /> Ali samples received? Yes No 0 All samples containers intact? Yes No❑ Descriptionisi match COC? Yes,, 140 C3 <br /> COC Received Emissivity: 0,rj F, Container: 64I Thermometer ID: t'1 <br /> — DaLelTime <br /> "i-lis t a <br /> ES so EDNO _ � <br /> Temperature:A t.Z -c 1 C ). PC Analyst Init Ipyj a <br /> SAMPLE CONTAINERS 1 2 I <br /> 4 8 6 7 8 9 10 <br /> OT GENERAL WNER;ALJ GENERAL PHYSICAL ( (3� t P-7 P, <br /> t <br /> PT PEUNPRESERVED C C C C G lv <br /> OT IN011GkNICCHEMIGVLMETALS C <br /> PT INORGAJVICC}IEMICALASErALS <br /> PT CYANIDE <br /> PT NITROG EN FORMS <br /> PT-1-OTA L SU LFID E <br /> 211x.NITRATE/NITRITE <br /> I'T TOTAL ORGANIC CARBON <br /> F'T"COX <br /> PT CIFEMLCALOXYGEN DEhGtND <br /> PU PIIENQLt CB <br /> 401.1 VOA trLA LTRA VEL BLANK �j <br /> on,t VOA%L4L 1 ,%, 1 f r tjfl { I 'a <br /> Q'I'EPA 413.1 4I3.1 418.1 <br /> PT OD011 ` <br /> RADIOLOGICAL <br /> R A CERT OLOCICA L <br /> 40 1.1 VOA VtA L-304 <br /> OT EPA 508160818080 <br /> OT EPA 515.118130 <br /> t T EPA 325 <br /> QT-EPA3!3TRA VEI:IICAN K'--"--.—.._..._._..._. _._.._._.__....-..__...._._.....----_._.._--- <br /> IOOmr EPA 347 <br /> 100.1 EPA 57 1.1 <br /> nT EPA 348 <br /> T EPA 599 <br /> OT EPA GIx <br /> t <br /> QT EPA 001 SNI ' <br /> T AMOER <br /> 8 07-JAN <br /> 31 O'L JAR <br /> SOIL SLFEVt <br /> 'P-C8%qAL <br /> PLASTIC DAC <br /> FF RRQOS:C <br /> ENCORE <br /> :ornments: - <br /> )ample Numbering Completed By: �,�)J oatetTime;-7 Ir. I, X325 <br /> =Actual t C=Correctud Lx:wocsrWnau,Lwe-ooCs+FORrnssarArlEczwPol <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document.This analytical repon 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 parry interpretation- <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bciabs.com Page 4 of 58 <br />