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Laboratories, Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1014319 Page 6 of 8 <br /> tl6 LAUUHA1 omeoe+�. ........ __ ..___,. _..... .. _ <br /> Submission4 ��` 5 9� <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express O UPS CI Hand Delivery ❑ Ice Cheslp,7 None ❑ <br /> SC Lab Field Service EP, Other 0(Specify) Box 0 Other 0,(Specity) <br /> Refrigerant: IcejP Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals Ice Chest Containers O None Comments: <br /> Inlarl7 Yes No❑ Intacl7 Yes No ❑ <br /> All samples,recaived7 Yes No All samples containers intact? Yes Na O Descriplipn(s)match eOC7 Yes No ❑ <br /> COC Received Emissivity: 01CL5_ container: /:14("10 ThermomewID: IU OatefTime �V'�'111 X25 <br /> f7,]:YES ONO Temperature:A 1 .lD '-CSCI C \&O -C Ana lysl Init .1V3Q <br /> SAMPLE CQNTAINERS I z z a s 6 7 8 a <br /> OT GENERAL MINEMU GENERAL PHYSICAL <br /> PT PEllNPRESERVED <br /> TINORGANICCHEMICALMETAIS <br /> PT INORGANIC CHEMICALM TAI S <br /> PT CYANME <br /> PT NITROGEN FORMS <br /> PTTOTALSULFmE <br /> 2oa_NITRATE I NiT1UTE <br /> PT TOTAL ORGANIC CAIIDON <br /> PT Tm <br /> PT CHEMICAL OXYGEN DENANO <br /> PIA PIMNOLICS <br /> 40.1 VOA VIALTIIAVEL OLANx <br /> 49.1 VOA VIII. 1 <br /> T EPA 1111 411.2 418.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> .HACTMOLOGICAL <br /> 40.1 VOA VIAL 5D4 <br /> TA 5 881BaB0_. <br /> T EPEPASIs/60.UMSO <br /> T EPA 525 <br /> TEPA 325 tRAVEL PLANE <br /> I OU.I EPA 547 <br /> 100.1 EPA 531.1 <br /> T EPA$48 <br /> T EPA 549 <br /> T EPA 612 <br /> T EPA 8015M <br /> T AMBER <br /> a 0Z)AA <br /> 32 OL JAR <br /> SOILSLEEVE <br /> PCD VIAL '.. <br /> PLAMCBAC <br /> FERROUS MON <br /> ENCORE '.. <br /> Comments: <br /> OalufTlme'. O" ^Y . <br /> Sa.pie NurnCamplbloa By: ,✓plaupeslwPaORAe uoc5lreftm515pnReCz.weol <br /> A=Actual I C=Oorradotl - <br /> The results in Ibis repos apply to the samples analyed in accordance rrith the chain of custodF document. 77ois analytical report must be reproduced is its entirety. <br /> All resu0s listed in this report are for the exclusive use of the sublllitting party BC Laboratories,Inc.assumes no responsibility for report alteration separation,dclachlnenl or third party interpretation <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.coni Page 9 of 58 <br />