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u <br />C <br />F <br />LJ <br />0 <br />0 <br />n <br />0 <br />J <br />l� <br />Laboratories, Inc. <br />Environmental Testing Laboratory Since 1949 <br />Chain of Custodv and Cooler Receint Form for 1401310 Pane 2 of 2 <br />BC LABORATORIES INC. COOLER, RECEIPT FORM Rev. No. 16 07/01/13 Page % Of <br />Submission A. y—. <br />SHIPPING INFORMATION SHIPPING CONTAINER <br />Federal Express ❑ UPS ❑ Hand Delivery Ice Chest None ❑ Box ❑ <br />BC Lab Feld Service Other ❑ (Specify) Other ❑ (Specify) <br />FREE LIQUID <br />YES ❑ NO ❑ <br />Refrigerant: Ice Blue Ice ❑ None ❑ Other ❑ Corranents:, <br />Custody Seals Ice Chest ❑ CoLrtalners None Comments: <br />inta <br />An samples received? YesZ No ❑ Ali samples containers Intact. Yes No D Description(s) match COC? Yes. No ❑ <br />COC Received EmissiV'y: Q' 1 —e Container. Ci Thermometer ID: �� Datarrime l % (J IZl b <br />OYES 0 NO Temperature: (A) I• `C / (C) �• -C Analyst loft <br />SAMPLE NUMBERS <br />SAMPLE CONTAINERS t 2 3 4 e e 7 a e to <br />OT GENERAL WUNERAIJ GVWReL <br />PT PE U?ORESERVED <br />INORGANIC CREbIICAL METALS G- G <br />rr INORGANIC CBEMICAL MET •l 12 12 <br />I'f CYANIDi�. <br />rrNrrxoGFORMs E E E <br />PT TOTAL FIDE <br />tax. NITRATE/NITR1TE <br />PT TOTAL ORGANIC CARBON <br />PT TOR <br />PT CHEA2ICAL O%YGI+N DEMIAFID <br />P►A 2'HENOLIcs A Z <br />40m1 VOA VIAL TRAVEL. BLANIL <br />4oml VOA VIAL. -3, t4 ! <br />T IPA 4 4181 <br />PT ODOR <br />RADIOLOGICAL <br />BACTERIOLOGICAL <br />40 ml VOA VIAL 504 <br />OT FPA 508t608B080 , <br />OT EPA 515JW9 <br />OT EPA 525 <br />OT EPA 525 TRAVEL BLAM <br />100m1 EPA 547 <br />10oml EPA 53L1 <br />e <br />T FPA 546 <br />T FPA 549 <br />QT EPA 632 <br />T EPA 8015M <br />gj AMBER <br />8 OZ. JAR <br />32 OZ JAR <br />SOIL SLEEVE <br />PCB VIAL <br />pyASPIC BAG <br />FERROUS IRON <br />ENCORE <br />SMART OT <br />Sttttuna Canister <br />Comments: <br />Sample Numbering Completed By: 14p, Date175ma <br />_ _ n _ r_._..,...,�lS:1MyDOfSlWordPerteetLLAB_r�OCS\FORNtSISANiRECt51 <br />The results in this report apply to the samples analyzed in accordance with the chain of custody document. This analytical report must he 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.bciabs.com Page 4 of 46 <br />