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m <br /> aceAna/ytica/ <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2601615 Page 3 of 4 <br /> PACE ANALYTICAL COOLER RECEIPT FORM Page Ofi_ <br /> Submission#: 2 o 9 b <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> I Fed Ex ❑ UPS❑ GSO/GLS❑ Hand Delivery ❑ Ice ChestWf None ❑ Box ❑ YES,6 NO L <br /> Pace Lab Field Service Other❑(Specify) Other ❑(Specify)) ) S <br /> I <br /> ;.Refrigerant:. Ice Blue Ice❑ None❑ Other❑ .Comments: <br /> Custod Seals iFIce%4est W, Gontamers❑. Non Comments: - <br /> ilhtact?Yes.O.'sNoa03 Irita�4?Yes�INo51O,;, <br /> All.samples.received? Yes No❑ All samples containers intact? Yes No❑ Description(s)•match COC?Yes No ❑' <br /> COC Received Emissivity: 0-9-1 Container: tJ A- ThermometerlD1 Date/Time�'/'L.�u' <br /> E& ❑NO Temperature: (A,) . ! 'U °C- / (C) .,2 l <br /> ( ! °C AnalystInit "I't <br /> SAMPLE NU613ERS _ <br /> SAMPLE-CONTAINERS •• <br /> 1 1 2 1 3 4 1 1 16 1 7' 1 8 1 9 1 10 <br /> T PE UNPRES 14 14 1 <br /> 4oz/Soz 16o PE:UNPRES <br /> 2oz Cr'6 <br /> TYNORGANIC CHEMICAL METALS I <br /> INORGANIC CHEMICAL METALS 4oz/Boz/16oz <br /> PT CYANIDE <br /> PT NITROGEN FORMS ( a <br /> PT TOTAL SULFIDE <br /> 26z.NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYGEN DEMAND I <br /> PtA PHENOLICS 40.1 VOA VIAL TRAVEL BLANK I A I({ <br /> y 40ml VOA VIAL —L' —c- —c, <br /> T EPA 1664B I _ <br /> PT ODOR I <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL- �-M ✓n� — %— /9— <br /> T EPA 508/608.3/8081A <br /> QT EPA 515.1/8151A <br /> T EPA 525.2 <br /> T EPA 525.2 TRAVEL BLANK <br /> 40.1 EPA 547 <br /> 40m1 EPA 531.1 <br /> Soz EPA 548.1 <br /> T EPA 549.2 <br /> T EPA 8015M <br /> T EPA 8270C <br /> Soz/16oz/32oz AMBER <br /> Boz/16oz/32oz JAR _ <br /> SOIL SLEEVE <br /> PCB VIAL <br /> 1 PLASTICBAG <br /> d , <br /> t TEDLAR BAG <br /> _ FERROUSIRON <br /> ENCORE <br /> SMART KIT <br /> SUMMA CANISTER IL <br /> Comments: <br /> Sample Numbering Completed By: DatelTime: 2 o Rev 2305/20122 <br /> A=Actual / C Corrected IS:tWPD°dlWordP°rfo°11LAe DOCSTOR6ISISAMREC,e 20I <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: 1001665505 4100 Atlas Court Bakersfield, CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 6 of 87 <br />