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m <br /> aceAna/ytica/ <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2601615 Page 4 of 4 <br /> PACE ANALYTICAL COOLERRECEIPT.FORM Page-1, Of.. Z. <br /> Submission#:Z 1 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS.❑ GSO/GLS❑ Hand Delivery 0 Ice Chestx None 0 Box ❑` YIES,6 NO ❑ <br /> Pace Lab Field Service Q/ Other❑,(Specify) Other ❑(Specify) I S <br /> Refrigerant: Ice J Blue Ice❑ None❑ Other 0 Comments: <br /> CtistodySeals Ice Chest q z 'rContalners❑ None' Comments: <br /> �'1� a�• 3. �,✓rrk� +., r if�'t�� <br /> alntact2,Yesi❑:�No3 Intact?.t�'e's�`!❑;�NO,.O� <br /> All samples.received? Yes No❑ ,"All samples containers,intact? Yes .,No❑ Description(s)match COC?Yes, No ❑ <br /> COC Received Emissivity: 0•9--4 Container: 1A- Thermometer ID:a� Date/Time'41-/VG MLI) <br /> ES 1]NO Tem erasure: A' <br /> P ( ) L-� °C / (C C.= Analyst'Init MI'i <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS- -- • <br /> 1 2 13 4 5 6 7 <br /> T PE UNPRES <br /> 40z.It / 6.o <br /> O PE UNPRES <br /> 20z Cr" <br /> TINORGANIC CHEMICAL METALS <br /> IN ORGANIC CHEMICAL METALS 40z/80 1160 <br /> PT CYANIDE <br /> PT NITROGEN FORMS , <br /> PT TOTAL SULFIDE <br /> 267..NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYGEN DEMAND <br /> PtA PHENOLICS <br /> 40m1 VOA VIAL TRAVEL BLANK <br /> 40.4 VOA'VIAL —L —G —(/ —G �[/ �•C✓ <br /> T EPA 1664B <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40ml VOAVIAL- ftMGL.t' L^='rC5- - — 12-- — <br /> T EPA 508/608.3l8081A <br /> QT EPA 515.1/8151A <br /> T EPA 525.2 <br /> T EPA 525.2 TRAVEL BLANK <br /> 40m1 EPA 547 <br /> 40ml EPA 531.1 <br /> Buz EPA 548.1 <br /> T EPA 549.2 <br /> T EPA 8015M <br /> T EPA 8270C <br /> 807./160z/320z AMBER <br /> 8-1160z/320z JAR <br /> V SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLAR BAG <br /> FERROUS IRON ' <br /> ENCORE <br /> SMART HIT <br /> SUMMA CANISTER t <br /> Comments: <br /> Sample Numbering Completed_By: Date/Time: P-23 06/20122 <br /> A=Actual I C=Corrected Is:INIPDo°iw°mP°K°.atn DOcsunRMstsuasec—z0] <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 7 of 87 <br />