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Laboratories, Inc. 61 <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1014319 Page 7 of 8 <br /> --•++�+.•v. mn� u.� unmrl.c nC4CIY I HUKM Rev.No.12 0613910/1 Page LjOfS <br /> Submissiontl:L'Q L I of <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express ❑ UPS O Hand Delivery ❑ Ice Chest None ❑ <br /> SC Lab Field Service Ep Other❑(Specify) Sox ❑ Other ❑,(Speci ty) <br /> Refrigerant: Ice?f Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals Ice Chest D Containers O None oComments: <br /> Inlacl7 Yes O Na leleLl7 Yes No ( _ <br /> All samples.received? Yes No D All samples containers intact? Ye NEED Descripllon(s)match COC7 Yes No ❑ <br /> COC Received Emisslvlty: Qi Comalner.(�}�—(�Thermomeu,ID: Il9 DafMTime 1P-4�—I11 <br /> I YES NO T <br /> Temperature:A,� •C l c d.p It, Analyst Intl -iOw <br /> SAMPLE CQNTAINERS 1 3 3 r1 <br /> y 5 11 9 <br /> OT GENERAL MINERAU GENEnAL PHYSICAL 10 <br /> PT PE 1/NPI ERVED <br /> T INORGANIC CHEMICAL METALS <br /> PT WGRGANIC CHEMICAL META LS <br /> PTCYANIDE <br /> PT}i nocEN FORMS <br /> PT TOTAL SULVME <br /> 1oi NITRATE/NITNTE <br /> PT TOTAL ORGAPDC CARHON <br /> PTTOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> PIA PHENOLICS <br /> 40m1 VDA VIAL TRAVEL 11 A <br /> 911.1 VOA VIAL 1 11 1 11 1. 1 1 1 1 1 1. <br /> T EPA 413.1 433.1 418.1 <br /> PT ODOR <br /> R DIDLOGICAL .._.. " . <br /> DACTENOLOGICAL <br /> 40 m1 VOA Vl y504 <br /> T EPA 508/609/90110.. <br /> TEPA515.0150 <br /> Tu <br /> EPA 535 <br /> T EPA S35 TRAVEL DLANR <br /> ]0aml EPA 547 <br /> 1 o0ml EPA 531.1 <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 617 <br /> T EPA B015M <br /> T AMBER <br /> 8 OL 3AR <br /> 33 OL JAR <br /> SOILSLEEVE 77 <br /> PCs VIAL <br /> -- <br /> PLASTICIJCHAG Ii <br /> FERROBSLRON 1 <br /> ENCORE <br /> Comments: <br /> Sample Numbering Camplclatl By: Datarrimep ' <br /> A=Actual / C=Conel;ted - IHeoocslYPOCIL B DOc91PORMSISFMIEC1WPe1 <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody document. 7/tis analytical report nn/st be reproduced in fis entirety. <br /> All results listed in this Depen are for the exclusive use or rhe submitting party BC Laboratories,Ina assumes no responsibility for report alleratiorl separation,detachment or third party interpretation <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 vvvvw:bclabs.com Page 10 of 58 <br />