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Laboratories Inc. ltl' <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1112910 Page 2 of 2 <br /> Sc LABORATORMS lhie -, - SAMPLE RECEIPT FORM Rev,44..12 1fet241�a Page {?! <br /> ubrtisson ! 4 <br /> SHIPPING INFORMATION HIPPING GC9N�AlAAER <br /> Federal Expfess ❑ UPS Q Hand Dellveiy ❑ Its Chest.` 9 ❑ <br /> BC Lab Field&orvice 2 Other L{apetify) Box li Other ❑($pacify) <br /> refrigerant: 1=71ff Blue Ice❑ t4one�1. Other❑ Com€nent� <br /> Custody seals lce chw❑ Cr�ntainers 13No,n --'Comments: <br /> 7ntatt4 Ycs . - Intact?YA%0 No 0)] <br /> Alt saiapfes cceived? Yeah HOC, All saniplft tonLail rs intacr7 Ye--,d 1400CfBrrCP pt{6 nQs}mafl6h b0 Z Y FS�tIo t3 <br /> COC Received ,• <br /> [Ep <br /> uiy: P_tlerm ef4[rtr tp:_)_( ___ €1�MrGimeSES C3 NO �ature:A r �C:l G `C` AnaFyaI.tnitP_" <br /> r�€.A?•IPLE COtlTAIGIEliS t 3 3 4 3 <br /> {2fi GbaFFaRL hyHERFta GEtiEst�Play xL:tit tl f r7 <br /> i'r PE rJL4T€tESEA'•'L.® _. <br /> YFIMItrA I I.LMICAL11ETAIS <br /> ' rrrr. ANlC0€073C;+,LP7E3A1$ [; ^ <br /> PT h ITKOCEN FORKS <br /> I x.iNrMATE l NITAITF <br /> PT TOX <br /> rT MICALoxk,F.tu <br /> PI'M <br /> fA •IYNCrLIcs <br /> r <br /> T F.A_i43.( tllF.ifa.l _ e <br /> FlftF51A7.OG'iLh.L. _. ,. <br /> R,ttGT3SR1 .1"i�lEJt1 _... <br /> ' T- h513,1 rS€57 <br /> 17T UA SIS <br /> TEpi€35 T 4rE1 7[L.hIFK <br /> T}JSP dl@ <br /> 8f3 <br /> . 'L�eA <br /> :N.07-tib' _. <br /> ]Ctll�1.CCt`E <br /> R VIAL _. <br /> 1.2—VCCIRE <br /> 58rnplo tri xnl3ering G prf+pl?°letd Mgr- .:t,J�L a Ga9cPT"ams-1'�i;��i ...!-rL•j�E;' raBLn9_iaadErr-rtnAsstsaat�ee7 tipLy <br /> A a.A.crual r is o-Cncrccted rft:•bUe= <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.bciabs.com Page 4 of 36 <br />