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17MLaboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1316179 Page 2 of 2 <br /> rest tfttsutttA r urtlts llvt:. GODLER RECEIPT FORM A.V.No.15 07101113,i!!!Page O11d <br /> Submission <br /> SHIPPING INFORMATION SHIPPING CONTAINER E LIQ <br /> Federal Express ❑ UPS❑ Hand Delivery Ice Chest.gP None ❑ Box ❑ ❑ N <br /> BC Lab Field Service," Other❑(Specify) Other ❑(Specify) <br /> Refrigerant: Ice 12r Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals Ice;Chest 13 Containers:&: None J� Comrnents: <br /> 7 <br /> All samples received? Yesg No❑ Ali samples containers intact? Yes;p' No❑ Description(s)match COC? Yes B"No ❑ <br /> COC Received Emissivity: O.Gs Container. p� Thermometer 1D: 217 <br /> Daterme8 !•13 '2200 <br /> ,�PYES ❑ fU0 <br /> Tempeeature: (A F °C 1 (C I }•II °C Analyst In$ ,5�5 <br /> SAMPLE CONTAINERS SAMPLE NUMBERS <br /> t 2 3 4 6 6 7 a 9 TD <br /> IT GENERAL.MINERAL!GENERAL <br /> r PE UNPR ESERYED pa- L, C G C 211 <br /> T INORGANIC 0101 1ICAL METALS <br /> r INORGANIC OMMICAL METALS DV (� <br /> r CYAN@E <br /> rKMOGENFORMS <br /> r TOTAL SULFIDE <br /> z NITRATE/NITRITE <br /> 'TOTAL ORGANIC CARBON <br /> 'TOX <br /> 'CHEMICAL OXYGEN DEMAND <br /> PHENOLICS <br /> nI VOA VIAL.TRAVEL BLANK A <br /> nl VOA VIAL <br /> 'EPA 4L'-i.4I3.L41&I <br /> ODOR <br /> DIOLOGICAL <br /> I <br /> CTERIOLOCICAL <br /> of VOA VIAL-504 _ I <br /> EPA 5DIV60MD88 <br /> EPA 515.718I50 <br /> A'$ SHUT HOLDING ME III <br /> EPA S'S TRAVEL BLANK ! Cr=a JO, NO SS 1 <br /> ri EPA 547 nn QI rzrtn flrLRQG COT I ` <br /> nl EPA 53 LI <br /> EPA 548 <br /> EPA 599 <br /> EPA 633 �l'!t\ Y LJ11 I i,ivv <br /> EPA 8815M <br /> 4MBER ( I.. SUB-O I LJ <br /> JAR <br /> 2.JAR <br /> SLEEVE <br /> VIAL <br /> MC BAG <br /> ROUS IRON <br /> ORE <br /> RT ICIT <br /> tna Canister <br /> nests- <br /> Is Numbering Completed By: Daterrime; •i.l 2 ;V <br /> 4ctual / C = Corrected <br /> The results in this report apply e P <br /> 1 to the les analyzed in accordance with the chain of custody document.This analytical report must be reproduced in its entirety. <br /> samples <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 parry interpretation- <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bdabs.com Page 4 of 33 <br />