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Laboratories Inc. Jik�_ <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1314316 Page 4 of 4 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.No.15 07/01113 Page Of <br /> Submission #: 455-f;{gl p <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Federal Express ❑ UPS❑ Hand Delivery Ice Chest None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service Other❑(Specify) Other ❑(Specify) <br /> Refrigerant: Ice P? Blue Ice ❑ None ❑ Other❑ Comments: <br /> ,ustody Seals . c ® None J47 Comments: <br /> \ll samples received? Yes _No❑ All samples containers intact? YesZ§�No❑ Description(s)match COC? Yey<Y No ❑ <br /> COC Received Emissivity: ().H`� Container: (�,l PE Thermometer ID: 2-0 7 Date/Time 4 I-3 2ILI0 <br /> YES ❑ NO <br /> Temperature: 1 A)_ I.Z °C / ( C ) L.3 °C Analyst[nit 5615 <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> -7 2 13 1 4 5 6 7 8 9 1 70 <br /> IT GENERAL MINERALJ GENERAL 4— <br /> T PE UNPRESERVED <br /> IT INORGANIC CHEMICAL METALS <br /> T-INORGANIC CHEMICM METALS ---- —- -_.. - <br /> T CYANIDE <br /> T NITROGEN FORMS <br /> T TOTAL SULFIDE <br /> oz.NITRATE/NITRITE <br /> T TOTAL ORGANIC CARBON <br /> T TOX <br /> T CHEMICAL OXYGEN DEMAND <br /> [A PItENOLICS <br /> )ml VOA VIAL,TRAVEL BLANK <br /> )ml VOA VIAL <br /> T EPA 413.1 413.2 418.1 <br /> r ODOR <br /> ADIOLOGICAL <br /> ACTERIOLOGICAL <br /> I mi VOA VIAL-504 <br /> T EPA 508/608/8080 <br /> T EPA 515.L8150 <br /> T EPA 525 — — - -- - <br /> T EPA 525 TRAVEL BLANK <br /> 10ml EPA 547 <br /> �0m1 EPA 531.1 <br /> r EPA 548 <br /> I <br /> r EPA 549 <br /> r EPA 632 <br /> T EPA 8015M ! <br /> r AMBER <br /> JZ.JAR...._ -... -.. -. <br /> OZ.JAR <br /> )LL SLEEVE <br /> :B VIAL <br /> .ASTIC BAG <br /> :RROUS IRON <br /> i <br /> 4CORE <br /> MART IfI'1' <br /> mnma Cauisler - <br /> nments: i <br /> 11111 f�liin,harinn t:nrnnl�r o.l h. .<�. n-....iz -� i 7 � <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 /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 6 of 30 <br />