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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1102917 Page 4 of 6 <br /> COOI.CR EiFCEIPT FORM A.,No.12 '2J30110 Page <br /> BC LA60RATOPIE6INC. OI <br /> Svdlmisslon#: _ � - <br /> SNIPPING INFORMATION SHIPPWG CONTAINER <br /> fee Cher None ❑ <br /> 8CL.Federal Express el pjUPS❑ Hand <br /> isV Delivery ;l t 0 Other ❑Opecilyl <br /> 80 Lnh F3a1B Service e-, other O ISPacityl aO% ❑ <br /> Refrige}ent: Ice 9—:;:;, Blue Ice ❑ None ❑ Other ❑ CmnmoRls: <br /> Cuslody Seats ICG Chest U CPntainers D Non c LKJCarmnents: <br /> a T <br /> All aawlee rPeaw d? YPs W.0 ��� <br /> All yimplu com+gfdrR imam? YvY NeelOeYpdpf7onlslsmWh COOT Y4113 No <br /> COC Received snl+elvar� .�'_L..� Cmtuiner. Tlwmnomntes to:i31w:�_ D+tUileM K�I tmj <br /> nNO <br /> YES �1 .3 •e J rcI —.•,�_ 'C Analyst snEt .- ' <br /> Temdewimc I A I <br /> SAMPLE NUrAm" <br /> SA1tfiE CCNTAINEPS + 0 5 e } e n In _ <br /> OT GERERAL n'zVimw 0smin,At HIVs GAl <br /> R PE VNYRTSEav1'U _ <br /> TIN C NI HEMICALM TAfs <br /> "rorORCANIC NPAhC,I ILTMs <br /> 'TCY vlac ,. <br /> TN a yH nni5 <br /> eTTATA :4FIOE <br /> lu..NRRATEIn'ITRITti <br /> M TO'IA PSLCANt AR N <br /> TTOX <br /> 1'1 rL11EhJl AI OYYLEN PCMAr <br /> •.�1'IIfN rlC+ <br /> n0.n,VnA VgAl TwJ.Ve tl aNN <br /> aandV 4 <br /> T Flz JIILNJ.t.a},, <br /> rt boort <br /> RAmOLOCIC+ __. <br /> 4. 'Y PI LI(A'L <br /> T r SUMOMMap <br /> T .rAS'fill <br /> T V,PA its <br /> PASIa"TRA VEL aWN" <br /> ,n+..s Asir <br /> Innwl rx 1. <br /> e.rA <br /> EYA ds9 <br /> TEPA 4" <br /> T FAAel <br /> T aAIRER <br /> OL JAR <br /> ]S OLJAR <br /> RVILSLEE't <br /> Ka NUL <br /> rsa W. <br /> FERR VE IRON <br /> LNCORE <br /> L'na�M+n[S; <br /> Semple RVelbvLld CmaPteted BT, - <br /> A•- Aetvsl ! C - Cnnativd .E 1q q ('' /71 /�Ct+� ¢:ubo.r•w..en�•Nntxp,oac5�e0eNs'cgwtem <br /> The renin in Iho repo"apply to the samples a»aiyred in accordance with the chain ofewtody dotvmeN.This ana),rical report must be reproduced in its entirety. <br /> All mwlb lured insbumpnauefort exclusiw useofdsc submiRNR puty.BC Lebommties,Ixassume w.,.,ibitity fm mount NteNtiov.sepandQA demh.-t w dmd pa1rY i-ouluunion. <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 x .bclabs.wrn Page 7 of 88 <br />