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= Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt form for 1012151 Page 9 of 13 <br /> aC LABORATORIES INC. ^ SAMPLE RECEIPT FOPM Ray.No.a M21M Page_Of z <br /> Submisslon#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Faderol Express t7 UPS Hand Usllvety p iee Chemt0 None ❑ <br /> BC L,ab Field Service Sy. Other (Spectty)_ _ Box ❑ Other D.(Spetify} <br /> Refrlgerant: Ice Blue Ice❑ None O Other 0 Comments- <br /> Custody Seals Ice Chest Q Containers C Nona Comments: <br /> - I mrc TYeY xe0 > as No <br /> r Ali samples recelved9 YvsK Nn❑ -AB samples contalnars lntact4 Yes( Nan Descrlptlonisl makh COC7 V leo ❑ <br /> ,.CES Rece B O Emis=_hrity: Cordainer. <br /> ,,,'r�`y 7lrerf ra peter l6: +fad ppl mF 2 f lj? l <br /> Temperature:A L1.0 T J C . t,{,(D 'Y Analyst.Mt (IbLI ZLD <br /> i <br /> Se,rylpl P.ImAEPA <br /> SAMPLE.CONTAINERS s r a a s c v fa s ro <br /> OT GENERAL NIVERAU GSKERAL_P:mSICA! <br /> PT PE LtVP"StWE0 <br /> AT INrle dr FlnrAl.AIF'I',LLS <br /> PT INORGANIC CJr MICAL hETAL.S <br /> rr TANIDE <br /> 'YT V1TAlMF.X M ' <br /> PT TOTAL SULME <br /> let NUBUTF rM1T m- <br /> AL ORGAKICCAR0014 <br /> PTTON <br /> RT rCAL OXYGEN DF D + <br /> PM PIIE8IDLICS <br /> amus V1 A).TRAA AHK ) _ <br /> agspi M1TIA VUL r f 1 s I 11 1 r _ I ) 1 1 <br /> rEYA 313 al3.t el B. <br /> RAUlOLOf.¢AI <br /> Ra WOLOGCAL <br /> pl A <br /> OT EPA U1sVJKWn`ya� <br /> T P i 5,I)BI% <br /> T EPA 525 <br /> LPX32sTRAV.1 xtA.N . <br /> I Wml EPn sag <br /> 10f)JIUA 55LI <br /> OT EPA Sf <br /> OT EPA sis f <br /> 7 UA 431 <br /> T LPA 8936~! - <br /> 'OT MBEA I( - <br /> 8 OLIAR <br /> 37 OLJAA <br /> SO11.1 EA'B ( <br /> PICO VIAL <br /> 1"LAMCPAr, ' <br /> EER OGS1poK <br /> ENCOAE �r <br /> Gammcnt5: <br /> SamPIR KU bcsing Concpmad By: Dpte:rRrne• — -i n <br /> The resvlrr in thio recon-p�r:;�/b±tam les ane ed in accordance with the chain c,',..r.c - M: <br /> P iY .�rj•docvmenL This anolytica!report matt he rzrv:_::.�_:.c:rs.eretir <br /> All malas listed in This rcaon ac for-:r r.clns+ve vu of as submininx wny.BC lahomtoriet,Inc um:na x msroosibility for Bryon allentioq separation,Wnch:vem:'crd Jrc�in[uyremtieo. <br /> 10g.Adas Coun Bakersfield,CA 93308 (661)327-4!ii. FAX(661)327-1918 v .bdabsmm Page 12 of 87 <br />