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Laboratories Inc. . <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1302261 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.Ya—13 (38117112 Page Ot <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Fedetal Express D UPS❑ Hand Delivery D Ice Chest None O <br /> BC Lab Field Service (d` Other O tSpecity) Box D Other D tSpec)ty) <br /> Refrigerant: Ice Blue Ice D None ❑ Other O Comments: <br /> Custody Seals Ice Chest❑ Containers D None Comments: <br /> 7 <br /> Alisamptes received? Yes No Cl All samples Containers imact? Ye No❑ DescAprionisl match COC? Yes No ❑ <br /> COC Received Emissivity: 'O Container: D Thermome{er 1� <br /> �� Date/Time 0-1- <br /> 4B YES O NO Anal st Init SU'. <br /> Temperature: (A I �r� `C l 1 C ) 1•� `C y _1�eC <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> t 2 3 4 5 fi 7 B 9 �p <br /> 07 GENERAL MINERAL/GENERAL PHYSICAL n? 6:6 <br /> PT PEINPRESERVEDfl! - <br /> T INORGAN)C CHEMICAL METALS <br /> PT mRGAmc amucA.L METALS <br /> PT CTANIDE <br /> {PT NM'ROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2oz NITRATE t NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOx <br /> PT CIMM)CAL OXYGEN DEMAND C� G <br /> PLA PHENOLICS <br /> 40m3 YOA VIALTLAVELBLAM <br /> 40ral VOA VIAL t'"1'3r r rJr s r 4r r r r r <br /> T EPA 4MI.4132.41L1 <br /> FT ODOR <br /> RADJOLOCI CAL <br /> BACTERIOLOGICAL <br /> 40 m1 VDA VIA2,504 <br /> T EPA 5NMOSIBOBD <br /> T EPA 5I53J8350 <br /> 7 EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 10D33ii EPA 541 <br /> 10Dm1 EPA 531.3 <br /> T Eh 540 <br /> QTEPA 54'9 <br /> T EPA 632 <br /> T EPA 80151,1 <br /> QT AMBER <br /> 8 OZ JAR <br /> 32 02 JAR <br /> SOIL SLEEVE <br /> PCD VIAL <br /> PLASTIC BAG <br /> FERROUS IRON _ <br /> EENCORE. <br /> SMART KtT <br /> Commems• <br /> Srrrriz Klunnb'arir._Cc 1pletee Ey: Cat=-lTm=_: - — <br /> A = Actnal t C = Cortecied <br /> TS:Uwrt)DCB\WwCAerleCnlJla DDG{FORNL41SAN41Et:RLt1 <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.bdabs.com Page 4 of 49 <br />