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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1904878 Page 3 of 3 <br /> BC LABpRATOMF,B INc. COOLER RECEIPT FORM Pa Of � . <br /> StE <br /> SHIPPING INFORMATION SHIPPING CONTAINER FAEE LIQUID <br /> FeUPS t7 Ontrac ❑ Hand Delivery leeCutts None ❑ Box 0 YES EI N0 0 <br /> BCice ID Other fSpatify) other O (specify] . _ w j <br /> Retregerent: <br /> ]coati Blue Ice 0 None Other ❑ Comment::: <br /> Custody Se Is tch� t >:,Ct}f�i�ir �rs t1 Nmttr�mments. <br /> . . <br /> • taot$'`Yai� rlyf s <br /> tAH =mje ro"1ve1'aa No [! All samptas contatnsre Intact? Ycc No I� Des4riptlonisl match C4G7 Yes No f]::d? <br /> eived EmisSIVRy. Container i � ktdmeter lO: netaftlme NO Tam craturer A ) _ _ °C ! f G 1 °C 2 t Analyst Ini <br /> SAMPLE NUMPERS <br /> SAMPLE COh*TAINERS - � _ <br /> ._. TPP, IBtPttPS <br /> 4w1Sax 11Eon Plsinrl'RY3 <br /> las <br /> T 1NOTtGAAYC CJW,?r1tCAL McTALS <br /> fhMIRMANIC'.CIRMICAL ALS4.411%zi16r2 <br /> PTCYANIDS <br /> PTNtTAOL'm fS <br /> 2n=. h9? <br /> PY• TY715 T 4 GANICCA1tn <br /> PT CIiFmlcm , GBN DBMANn _.._... _. _ . <br /> A MM2s`OLICS <br /> 40nu VGA VIAL T1tA% It BLANK <br /> 4kni 0 VIAL <br /> PY ODUR <br /> RADIQLOc7 L — <br /> BACTPtUo113r AL ' <br /> 40In) VOt VIATr5F4 <br /> pT 8PA 5b&faFt30S0 _ _ <br /> EPA 5TA1tE[SD <br /> Y' EPA 525 <br /> T : AS.ISTRAVBLRtANK <br /> 1 EFA Bit-_- <br /> dOml $P.l53Lt ._ _. <br /> LIZ <br /> _ _ EPA 349 <br /> T EPA 8015M <br /> T EPA B370 _ <br /> IL 5L> EVE / PC #t A <br /> PCD VIAL <br /> FUSTIC wwo <br /> t RRAG <br /> 6 ,,. 0USIIt0N <br /> 24CORE - <br /> WARrMT <br /> SUMN A. CANISMIt, - <br /> CoOtmants: <br /> Sample Numbarinrg Comploted 8Y _a . psiolTlmet Rtvza 05r2ax,10 <br /> F4 =+ Actual f C = Conactad int ao�w,ar�n�,us to.1r east u�,ta„ 1pI <br /> The results• in this report apply to the soneples rmuly_ed in accotr/anc•e with the chain of cusiody document . '!•bis analytical report taum be reproduced in its entirely. <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: 1000854621 4100 Atlas Court Bakersfield, CA 93308 (661 ) 3274911 FAX (661 ) 327-1918 www. belabs.com Page 6 of 40 <br />