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— Laboratories Inc. �,��,�.�1 <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1414263 Page 2 of 2 <br /> ,ABORATORIES INC. COOLER RECEIPT FORM Re,No.17 06/05/14 Page Of <br /> Submission#: l LA-k L-k D(0 3 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Federal Express ❑ UPS❑ Hand Delivery ❑ Ice Chest None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service g Other❑(Specify) Other ❑(Specify) <br /> Refrigerant: Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals I Ice Chest❑ [:LC.n�talners❑ None Comments: <br /> > Yes n N. ril <br /> All samples received? Yeg,,i4--No❑ All samples containers intact? Yes`'—N.❑ Description(s)match COC? Yes2j,/_No ❑ <br /> COC Received Emissivity:D-1� Connitainer: Its Thermometer ID: _ Date/Tim,(o(7[r f tt(c�13 0 <br /> ES NO Temperature: (A) `- \ °C / (C ) ( S °C Analyst Init to <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 2 3 4 5 6 1 7 1 8 9 10 <br /> T GENERAL MINERAL/GENERAL <br /> PT PE IINPRESERVED <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2—NITRATE i NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> I'T CHEMICAL OXYGEN DEMAND <br /> PIA PHENOLICS <br /> 40.1 VOA VIAL TRAVEL BLANK <br /> 40.1 VOA VIAL t t f t <br /> T EPA 4131 413.2 418.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> T EPA 508/608/8060 <br /> T EPA 515.1/8150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 40.1 EPA 547 <br /> 40.1 EPA 53L1 <br /> Boz Amber EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 8015M <br /> 1'AMBER <br /> 8 OZ.JAR <br /> II <br /> OZ.JARI.V O� <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> FERROUSIRON <br /> ENCORE <br /> SMART KIT <br /> Summa Canister <br /> Comments: <br /> Sample Numbering Completed By: Date/Time: ti [S:[WPDoc[WordPerfecnLA8_DOCSTORMSISAMREC16 <br /> A = Actual / C = Corrected -. <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody docnuneni.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. BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1000250324 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 19 <br />