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BC LABORATORIES INC. COOLER RECEIPT FORM Rey.No. 16 07/01/13 PageC-'Of <br /> Submission #: jq.3/(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 /> I <br /> Refrigerant: Ice F? Blue Ice ❑ None ❑ Other ❑ Comments: <br /> Custody Seals ivr. Cor..-P.i01�-Fr: � None A7 Comments: <br /> .1.1L1- <br /> All samples received? Yes No❑ All samples containers intact? Ye -Alo❑ Descriptionls]match COC? Yq]' No ❑ <br /> COC Received Emissivity: .`IT Container:jDA PF _ Thermometer ID: 20� <br /> DYES El NO Date/Time-714113 21210 <br /> Temperature: (A ) —L.Z—°C 1 ( C 1.__. •3 °C Analyst InIt -SA.5 <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 23 4 r, B 7 8 9 1D <br /> T GENERAL MINERAL!GENERAL <br /> PT PE UNPRESERVED <br /> IN RGANIC CHEMICAL METALS <br /> PT-INORGANIC CHEMICAL-NM 'ALS <br /> IT CYANIDE <br /> IT NITROGEN FORMS <br /> IT TOTAL SULFIDE <br /> 20z.NITRATE I NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> PIA PI�ENOLICS <br /> 40m]VOA VIAL TRAVEL BLANK <br />.40m1 VOA VIAL <br /> T EPA 413.1 413 418.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> T EPA 508160MOBO <br /> T EPA 515.118150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLAND I <br /> 100ml EPA 547 <br /> i <br /> 104m1 EPA 531.1 <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 8015M <br /> T AMBER <br /> 3 OZ.JAR <br /> 32 OZ.JAR <br /> ;OIL SLEEVE <br /> 'CB VIAL <br /> 'LASTIC BAG <br /> ,ERROLIS]RON <br /> I <br /> iNCORE <br /> iurrrna C:r-.rl:;Icr <br /> -,niplkr Oijmb�rRn -0111-,51etacl: <br />