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VM Laboratories "nc.0. <br />MorEnvironmental Testing Laboratory Since 1949 <br />Chain of Custody and Cooler Receipt Form for 1717141 Page 2 of 2 <br />BC LABORATORIES INC. COOLER R ,CEIPT FORM Page Of <br />Submission #: — <br />SHIPPING INFORMATION <br />Fed Ex ❑ UPS ❑ Ontrac ❑ Hand Delivery ❑ <br />BC Lab Field Service X Other ❑ (Specify) <br />SHIPPING CONTAINER <br />Ice Chest (0 None ❑ Box ❑ <br />Other ❑ (Specify) <br />FREE LIQUID <br />YES ❑ NO ❑ <br />W S <br />Refrigerant: Ice W Blue Ice ❑ None ❑ Other ❑ Comments: <br />Custody Seals i <br />het 17 _ <br />Containers p <br />None 91 Comments: <br />All samples received? Yes No O All samples containers intact? Yes No ❑ Description(s) match COC? Ye No ❑ <br />COC Received <br />® YES ❑ NO <br />Emissivity: I c Container: _�k)A Thermometer ID: a,QS_ Date/Time Q <br />Temperature: (A) °C / (C ) -C Analyst Ink <br />• SAMPLE NUMBERS <br />SAMPLE CONTAINERS <br />t 2 3 4 5 6 7 8 9 to <br />T PE UNPRES <br />4oz I Box I16oz PE UNPRES <br />202 Cr*1 <br />T INORGANIC CHEMICAL METALS <br />INORGANIC CHEMICAL METALS 4oz / Boz / 16oz <br />PT CYANIDE <br />PT NITROGEN FORMS <br />PT TOTAL SULFIDE <br />lox. NITRATE/ NITRITE <br />PT TOTAL ORGANIC CARBON <br />PT CHEMICAL OXYGEN DEMAND <br />PtA PHENOLICS <br />40ml VOA VIALBLANK o <br />40.1 VOA VIAL <br />r <br />_ <br />T EPA 1664 <br />PT ODOR <br />RADIOLOGICAL <br />BACTERIOLOGICAL <br />40 ml VOA VIAL- 504 <br />T EPA 508/608/8080 <br />T EPA 515.1MIS0 <br />� <br />T EPA 525 <br />T EPA S25 TRAVEL BLANK <br />40mi EPA 547 <br />40m1 EPA 531.1 <br />Boz EPA 548 1 <br />T EPA 549 <br />T EPA 8015M <br />T EPA 8270 <br />Sox / 16oz / 32oz AMBER <br />Roz / 16oz / 32oz TAR <br />SOIL SLEEVE <br />PCB VIAL <br />PLASTIC BAG <br />TEDLAR BAG <br />r <br />FERROUSIRON <br />ENCORE <br />SMART KIT <br />SUMMA CANISTER <br />Comments: <br />Sample Numbering Completed By: Date/Time: to qZ6 05/2312016 <br />A = Actual / C = Corrected Is:tv+voonwwdr;rtHnrne_Docs,roamssnmaEa�20I <br />The results in this report apply to the .samples analyzed in accordance with the chain ojcustody document. This analytical report must he 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 />Report ID: 1000621887 4100 Atlas Court Bakersfield, CA 93308 (661) 327-4911 FAX (661) 327-1918 www.bclabs.com Page 4 of 12 <br />