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aceAnalytical <br /> ENVIRONMENTAL*SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2214240 Page 5 of 5 <br /> PACEANALYTICAI _ COOLER RECEIPT FORM Page—::/--Of <br /> Submission <br /> SHIPPING INFORMATION " SHIPPING CONTAINER FREE LIauID <br /> Fed Ex C UPS O 0501 GLS�6 Hand Delivery u Ice Chest��7✓S L, None C Box _I YES'L tic" <br /> Pace Lab Field Service ❑ Other 0(Specify) Other td(Specify) 1f�1 j g <br /> Refrigerant; it ' Bluc Ice❑ None❑ Other❑ Comments: <br /> I <br /> Custody Seals I e Chest❑O Containers CJ Non c Comments; <br /> In1A'I7 Yns N1n IWact?Yes LI No L3 <br /> All samples receNed? Yes,— ?to C Alf samples containers intact? Yew No L DescriDtionfsi,match COC?Yej.E'iN,o i <br /> OC Received �misslvlty: .0 Contaln1er:CL4L n a-eterIQ- � DaViTime&�l—O'�Z' <br /> YES C1 NO Tumpera7ura: t A J f 'C J f C } 2 C kraI-V s,Ir <br /> SArr?l.F.Nl)f,1P'c�.5 <br /> SAUPLE CONTAINER. — --- --- <br /> I 1 I ] 1 1 <br /> R7 PF,INMt'S <br /> PE WIPRP.S <br /> cr' <br /> T Icnu.An uF,+atruLSlrrAls y I <br /> 'rvQu(:A�ICCH6it111aL�IET.tt3 rrTor r7dee <br /> I I'1'S'l'AFIDE <br /> I,I Ni ixo[:Ev r•UH?IS <br /> PT'roTALsI'LFIDF. <br /> lox.N(TRATE1 VrMIT E <br /> PI'MI'ALCIRGANlf CARIVN <br /> FI'C'HE:\IIC•ALOSYCES DEALIND <br /> PIA P/P% I <br /> ec:.11rc1A ViAL'1'141V''i,ttL.4\'IC _ ...____ t <br /> 45.d VOA VIAL. <br /> T EPA 166411 I <br /> RADIOLOGIC:AI. <br /> kNICT 0 to 1,10 G 10 . <br /> N nd VDA VIA LS04 <br /> QT sC .MVJ,-J1MIA <br /> l <br /> Q7 EPA 3t3.1fa151,\ <br /> 07 fl1U <br /> 1 l EI•A STSd TRAVEL BLANK — <br /> JonJ EfA SJ' I <br /> Jan)EI'.t U Ll <br /> $ot Ll-.%SM1 <br /> T EPA 01 s,1 <br /> CIT LPA Ir.-W i <br /> A-,,ltocf22w ANW:lt <br /> 501L SLEEVE 1 <br /> PCR VIA 1. _.. <br /> P ANTIC AAC <br /> TF.DLAR BAG - --- <br /> fr.h1t11.S INTI% <br /> ENCORE <br /> sua;n.aL.tnuTER I i <br /> Comments: _ <br /> Sample NurpDering Completed By: f —L� Ga:c�Tme j_n___) ;�"L ft,toosmna <br /> A=Aetuat , C=Corfoet'?d p•u. ra�Hrtire.rtnt-eocsrnwrasu_rewr rl <br /> The results in this report apply to the samples analyzed in accordance with the chair)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. Pace Analytical assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> ReportID: 1001318187 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 8 of 79 <br />