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1 <br /> ' — to <br /> Laboratories Inc. � ,� <br /> Environmental Teslin8 Laratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1204246 Page 4 of 6 <br /> tBC LABORATORIES INC. SAMPLE RECEIPT FORM Rev.No.11 0612WOB Pae Of <br /> Submission#: 2 <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Expre / <br /> ss ❑ ��P S O Hand Delivery ❑ Ice Ches None 0 <br /> BC Lab Flat <br /> d Service t Other O(Specify) Box ❑ Other O(Specify) <br /> ' Refrigerant: lceW Blue Ice❑ None O Other❑ Comments: <br /> Custody Seals Ice Chest❑ Containers❑ - None Comments: <br /> n c?Y11 Co <br /> ?Ys N <br /> All samples received? Yes No O All samples containers Intact? Yes No 0 Oescrlpllon(s)match COC? Yes 0 No O <br /> COC Received NO ived Emissivity: V r 1b Container. fJ•Ir'I2D Thermometer lD:�� Datartlme I� <br /> YES <br /> TemperaWre:A b •� •C / C ) �� •C AnaiysHalf .INLJ 2� <br /> iSAMPLE CONTAINERS t r a i S i i t 1 la <br /> OT GENERAL MINEaAI/GENERAL PHYSICAL <br /> IT PE UNPRESERVED <br /> T WORCANICC MICAL METALS <br /> PT INORGANICCHEMI ETA" <br /> PT CYANIDE <br /> PT NITROGEN DISMS <br /> PT TOTAL SULFIDE <br /> lec NITRATE/NI Rtl'E <br /> PI TOTAL ORC.tuNIC CAJFLBON <br /> PT TO% <br /> PT 9MEMICAL OXYGEN OLAIANU <br /> PLA PHLNOLIrS <br /> 49.1 VOA VLAL TWILL.DLANK <br /> 40mI V A VIAL I 1 1 1 1 1 I 1 1 I I I <br /> T EPA 415.1,13.1418.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> ' BACTEWOLOCICAL <br /> IO,IVOA VIAL_504 <br /> Qj EPA WIVUB/BDSY <br /> T EPA 515.19150 <br /> ' -QT_EPA 555 <br /> T EPA 355 TM VEL BLINK <br /> 100,1 EPA W <br /> ' 100,1 EPA 11I.1 <br /> T EPA Sia <br /> Qj EPA SJ9 <br /> T EPA 655 <br /> ' 91 EPA 1013NI <br /> T AMBER <br /> e oz JAR <br /> ES OL . <br /> SOILSLEEVE <br /> PCB VLAL <br /> PLASTI BAC <br /> FERROUS IRON <br /> ' ENCORE <br /> Comments: <br /> Sample Numbering Completed By: DalefTime: <br /> A=Actual I C=Corrected IH;saoc5\Vl VimaAfi OMSsFORN515ANRECE.NPoI <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document.This analytical report most be reproduced in its entirety. <br /> All remits Jerred in this repo",e for the ead jt,va ae of the submitting perry. BC Labomtorio,Inc.assumes no responsibility for report alwation,separatioq detachment or third parry interpretation. <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 yyyn,v.bclabs.com Page 7 of 88 <br />