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Laboratories Inc. _ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1601186 Page 3 of 4 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM page_j Of. Z <br /> Submission #: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac El Delivery ❑ Ice Chest None ❑ Box [I YES ❑ NO ❑ <br /> BC Lab Field Service Other❑(Specify) Other (Specify) <br /> Refrigerant: Ice& Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals Ice Chest❑ Containers❑, Nonef Comments: <br /> !- <br /> All samples received? Yes No❑ All samples containers intact? Yes No❑ Description(s)match COC? Yes No// ❑ <br /> COC Received Emissivity: _ Container: _ Thermometer ID:_2_ Date/Tim, I <br /> YES 1:1NO Tem erature: (A) 6 °c / (C I O. 3 <br /> °C Analyst[nit <br /> ` SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 2 3 4 5 6 7 8 <br /> T PE UNPRES 9 10 <br /> 40z/8oz/16oz PEUNPRES <br /> 2oz C", <br /> T INORGANIC CHEMICAL METALS <br /> INORGANIC CHEMICAL METALS 4oz/8oz/16oz <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 20Z.NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYGEN DEMAND <br /> PtA PHENOLICS <br /> 40.1 VOA VIAL TRAVEL BLANK <br /> 40.1 VOA VIAL <br /> T EPA 1664 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL•504 <br /> T EPA 508/60818080 <br /> T EPA 515.1/8150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 40m]EPA 547 <br /> 40ml EPA 531.1 <br /> 8oz EPA 548 <br /> QTEPA 549 <br /> T EPA 80I5M <br /> T EPA 8270 <br /> 8oz/16oz/32oz AMBER <br /> 8oz/16oz/32oz JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> ?LASTIC BAG ' <br /> rEDLAR BAG <br /> �ERROUSIRON <br /> ;NCORE <br /> MART KIT <br /> I <br /> UMMA CANISTER f <br /> mments: <br /> mple Numbering Completed By: Date/Time: <br /> = Actual / C= Corrected Rev 20 07/24/2015 <br /> tS:tWPDOCIW°rdP,,fcCQLFB DOCSIFORMSISAMREC,e,20t <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 party interpretation. <br /> Report ID 1000439944 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 5 of 30 <br />