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Laboratories, Inc. �U�, <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1298782 Page 3 of 6 <br /> BC LABORATORIES INC" GOOLLH RECEIPT FORM Rev.No.13 US/17112 Page L oLL <br /> Submission #: - <br /> sHiPPiNG INFORMATION S,iIWING CONTAINER <br /> Federal express U UPS❑ Mand Delivery ❑ Ice Chest � None ❑ <br /> BC Lab Field Service Other El(Specify) Box ❑ Other Q(Specify) <br /> Refrigerant: Ice 81ue Ice O None❑ Other❑ Comments: <br /> Custody Saals Ica Chest ❑ L�Co�ntalners❑ None Comments: <br /> All samples raceived? Yes No O All samples containets.lntacl? Y No p Oescrlutianisl match COC? Y No ❑ <br /> COC Rt:Ceived Emisslvily:Q,, 5 Container Thermometer lD_C�V� paterTima l �2� <br /> Yrs © NO <br /> S5 <br /> Temperature: I A) �•3 `C i !C I� "C ?�nalyat /nit <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 7 3 $ A a 6 7 a 9 10 <br /> OT GENERAL MINERAL/GENERAL PHYSICAL i A <br /> PT PE UNr'REsSER V Ep <br /> DT INORGANIC CEMKICALh1ETAtS <br /> P"1'INORGANIC UEEMICAL METALS <br /> PT CYANIDE <br /> Pr NITROGEN POINTS <br /> PT-roTAL SULFIDE <br /> Ann"1�`rrRATT I NITFUTE <br /> PT TO'T'AL ORGANIC CARIION <br /> PT TOX — <br /> P'r CHrmiCALo%a'GxN DEMAND <br /> PIA PIIENOIArS <br /> -41"VOA VIAL'rRAVE:I.BLANK <br /> 40m)VDA VIAL I <br /> I <br /> T EPA 413.1.4Ud.46.1 <br /> P- ODOR <br /> BACI U11101.0VICAL <br /> 441 ml VOA V IAL-504 <br /> Ul'EVA sutlMorialllu <br /> T LPA&IS.vH150 <br /> T EPA Si; <br /> T EP,1 52S TRAVEL 1R.ANIi <br /> 1HUmlEPA 547 <br /> 1 Unit EPA 531.1 <br /> T EPA 54H <br /> T EPA 547 <br /> gT 1111A 47! <br /> 1'EPA 6615A1 <br /> o'r AMBER <br /> ROZ.JAR <br /> 2 M J,If <br /> SUIL5LEi:s1_ <br /> PCtl VIAL <br /> 11LA.l'IC RAC <br /> FE lROuS moi'/ <br /> GNf.'nN F. <br /> saLaiirsl'r w -- <br /> Gamments: <br /> Sample Numboriilg Ccmplelad 13y; <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document. This analytical report must be reproduced in its entirety. <br /> All results listed in this report are for the exclusive use of the submitting party BC Laboratories,Inc.assumes no responsibility for report alteration separation,detachment or third parry interpretation <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 6 of 60 <br />