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ace Analytical <br /> 1 ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2520507 Page 2 of 2 <br /> PACE ANALYTICAL COOLER RECEIPT FORM Page Of <br /> Submission#: —`�471 1 I <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE 1QUID <br /> Fed Ex [I UPS❑ GSO I GLS[I Hand Delivery ❑ Ice Chest V None ❑ Box ❑ Y ' NO ❑ <br /> Pace Lab Field Service Other❑(Specify) Other (Specify) f S <br /> Refrigerant: Ice BIue Ice C] None❑ Other❑ Comments: <br /> Seals Ice Chest Custod y.y 01 Containers d None Comments: <br /> 'lntact7Yes.[9vN6FON hfact?Yes 6-No b <br /> All samples racoived7 Yes No- All samples containers f ntact7 Yes No❑ Description(5)match COG? Yes No ❑ <br /> COG Received Emissivity:G � Container. Thermometer ID:TR% DatefT3me 1'{!1 3LLU <br /> ? 7 <br /> Z—TYES ElNO Temperature: (A) -C I (C } f' 1 -C Analyst Init,vrpf <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 2 3 4 5 6 7 8 9 10 11 <br /> T PF,UNPRF.S <br /> 4oz 18az I6az •E UNPRES <br /> 2uz Cr'� <br /> T INORGANIC CHEMICAL METALS ' <br /> INORGANIC CHEMICAL METALS 4oz!8oz 116oz I <br /> PT CYANIDE <br /> PT NITROGEN FORMS �- I <br /> PT TOTAL SULFIDE I <br /> uz.NITRATE/NITRITE. <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYf.FN DEMAND <br /> PtA PnENOLICS <br /> 40.1 VOA VIAL TRAVEL BLANK <br /> 40.I VOA VIAL <br /> 7'EPA I664R <br /> PTODOR <br /> RAIIIULOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA-VIAL.504 <br /> T EPA 5081608.3t8081A I <br /> QT EPA 515.I18151A <br /> T EPA 525.2 <br /> T EPA 525.2 TRAVEL BLANK i <br /> 40.1 EPA 547 I <br /> 40.1 EPA 531.1 I <br /> 8oz EPA 548.1 <br /> T EPA 549.2 <br /> T EPA 80I5MI I <br /> T EPA 8270C I <br /> 8oz 116oz 132oz AMBER I <br /> 8oz 116oz/32w.JAR I <br /> SOILSLEEVE I <br /> PCB VIAL I <br /> PLASTIC BAG <br /> TEDLAR BAG <br /> FERROUSIRUN <br /> ENCORE <br /> SMART KIT I <br /> SUMMA CANISTER <br /> Comments: <br /> Sample Numbering Completed By: DatefTime: / f r)w 2308120/22 <br /> A=Actual / C=Corrected 201 <br /> 1I x <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. Pace Analytical assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1001642043 4100 Atlas Court Bakersfield, CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 4 of 10 <br />