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]M�-�atratorInc.al Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1204246 Page 6 of 6 <br /> ' BC LABORATORIES INC. SAMPLE RECEIPT FORM Rev.N. a 06124sm, Page _ <br /> Submission N: (a <br /> ' SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express Cl WS❑ Hand Delivery ❑ Ice Chas None O <br /> BC Lab Field Service Other O(Specify) Box ❑ Other ❑(Specify) <br /> Refri erant: Ice I�D Blue Ice❑ None❑ Other❑ Comments: <br /> Custody SeatsIce Chesl 11Copla(rier�❑ None Comments: <br /> In ?Y•s No I <br /> ' All samples received? Ye No D All samples containers Intact? Ye No O Description(s)match COC? Yes O No ❑ <br /> COC Received Emissivity: 0Iglb Container: Thermometer 10: Daterrime $-e'�a <br /> YES ❑ NO 11 2a <br /> Temperature:A ,t1 •C I C H•—( •C Analyst[nit .I N O <br /> SAMPLE CONTAINERS ( i(p t • 9 l4 <br /> OT GENERAL MINERAL?GENERAL PHYSICAL <br /> ' PT PE UrIPRESERVED <br /> T IMORGANIC CHEMICAL METALS <br /> PTI?10 ANICCREMICALMITALS <br /> PT CYANIDE <br /> ' PT NITROGEN FORMS <br /> tj TAL SULFIDE <br /> Iov NITRATE I NITRITE <br /> PTTOTAL ORgANiC ON <br /> PT TOx <br /> PT CHEMICAL OXYGEN DMANS <br /> PIA PMNQLtCS <br /> 40.1V A TRAVEL BLANK <br /> 40.1 VOA VIAL 1 1 I I 11 I 1 1 <br /> TEPA 4U.1 413.1.4 ULI <br /> PT ODOR <br /> BACTERIOLOGICAL <br /> 40 ml VOA ML-Sh <br /> T EPA SOV60818080 <br /> T EPA 50.VBL59 <br /> T EPA s35 <br /> T EPA SES TRA V EL BLANK <br /> 100.1 EPA 347 <br /> 100.1 EPA 531.1 <br /> T EPA 543 <br /> T EPA 549 <br /> T EPA DI <br /> T EPA$015A1 <br /> T AMBER <br /> 104 1A,it <br /> lI OL LAR <br /> ' SOILSLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> 'FERROUS IRON <br /> ENCORE <br /> Comments: <br /> Sample Numbering Cpmpleled By: pairr i I, <br /> 4=Actual I G=Cprrecled IN;IppCSIWp•O,IAe�p:91FpgM91$AMglC2'M01 <br /> The results in this report apply to the samples analyzed in accordance faith the chow ofcustody document.This cnalyinnl report must he reproduced in its entirety. <br /> All oaulo luted in"is.port are for the exclusive useof d,esubmia6ug parry. BC Laboratories,Inc assumes no responsibility for repon alteration,separation,detachment or third party interyretation. <br /> ' 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 vAVW.bclabs.com <br /> Page 9 of 88 <br />