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— Laboratories Inc. <br /> ' — <br /> Environmental Testing Laboratory Since 1849 <br /> Chain of Custody and Cooler Receipt Form for 1204246 Page 3 of 6 <br /> ' BC LABORATORIES INC, SAMPLE RECEIPT FORM Rev.No.13 06t141f9 Pa e_ f <br /> Submission#: L <br /> SHIPPING INFORMATION HIPPING CONTAINER <br /> rFdLral Express O WS❑ Hand Delivery O Ice Chas None O <br /> ab Field Service STI/ Other O(Specify) Box O Other O(Specify) <br /> _] <br /> Refrigerant: Ice1W Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals Ice Chest❑ Containers O - Nonex Comments: <br /> In T Yes No Ina 7 e <br /> All samples received? Yes No D All samples containers Intact? Ye No O Description(s)match COC? Vas O No O <br /> COC Received Emissivity: Q q16, Container:Lbila- Thermometer ID:VI`l Datemme - -� <br /> YES ❑ NO <br /> Temperature:A 11 •C 1 C C Analyst loll <br /> ' SAMPLE CONTAINERS t J l 4 S r ) r 5 to <br /> OT GENERAL MINERAL/GENERAL PHYSICAL <br /> PT PE UlePRESERVED <br /> ' T LNORCANIC CHEMICAL METALS <br /> PT OIORCAHC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITX0cEN FORMS <br /> PT TOTAL SULFIDE <br /> Ja>_NITRATE t NITRJTE <br /> PT TOTAL ORGANIC CARBON <br /> PTT x <br /> PT CHEMICAL OXYGEN DEhLWD <br /> PSA HENOLICS <br /> 40.1 VOA VIAL TRAVEL BLANK <br /> ' 40.1 VOA VIAL I 1 1111L 1 I I 1 1 1 11 <br /> 42T EPA 413.1,413.2,4 18. <br /> PT DOR <br /> ;RADIOLOGICAL <br /> ' <br /> BACTERIOLOGICAL <br /> 40 mi VOA VAL-504 <br /> T EPA 508/60918080 <br /> T EPA 5IS.III" <br /> QT EPA 515 <br /> T EPA 515 TRAVEL BLANK <br /> 100.1 EPA M7 <br /> 100.1 EPA 531.1 <br /> ' TEPA 548 <br /> T EPA 549 <br /> T EPA Us <br /> T EPA 80 15N <br /> ' QT AMBER <br /> 9 OL JAR <br /> 33 OL J.AR <br /> SOILSLEEVE <br /> PCB VLAL <br /> PLASTIC BAG <br /> FERROUSIRON <br /> ENCORE <br /> Comments: <br /> Sample Numbering Completed By: DaleRime: <br /> A=Actual I C-GoRecu.1 IH]DOCSIWPIML e- SIFORMSISAMREC^-.WPeI <br /> The mobs in this report apply to the samples analyzed in accordance with the chain ofeusmdy document This analytical report most be reproduced in its emo ery. <br /> All results tilled in this reportare for rhe exclusive use of the submitting terry. BC Laborema.,Inc.assumes no rupomibility for reportalteration,separation,detachment or third party interyretation. <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 iiiww.1hclabs.com Page 6 of 88 <br />