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Laboratories Inc. I L <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717189 Page 2 of 2 <br /> PdE <br /> ATORIES INC. COOLER R EIPT FORM Pae Of <br /> on#• <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> UPS❑ Ontrac❑ Hand Delivery ❑ ice Chest® None O Box ❑ YES ❑ NO ❑ <br /> ld Service IR Other Q(Specify) Other ❑(Specify) W I S <br /> t: lee 9 Blue Ice❑ None❑ Other❑ Comments: <br /> eals �Gt"� ;s L¢{Et )asra'[1. None IN Comments: <br /> received? Yes P No O AFI samples containers intact? Yes No❑ Deser$rtfen(s)match COCT Yes No ❑ <br /> GOC Received Emissivity: a Container:_)Ana Thermometer iD:208 DateITtm <br /> ®YES ❑NO Tem ture: (A) .- °C / IC-1 °C I.Anallyst hdt <br /> SAMPLE NUMBERS <br /> SAMPLE CONTA96 M <br /> 1 2 9 4 6 a 7 a <br /> Or P$UNPRES <br /> 4oa/11as/16oa PEUNPRRS <br /> OT INORGANIICCER IICALh=ALS _ <br /> INORGAMC CEffi1SICAL MRTALS 4m/sea/16ez t <br /> PT ANLD <br /> PT NITROGRN FOWO <br /> PT AL E <br /> los.NITRATE/NMRtITB <br /> PTTOTAL ORGANIC CARBON <br /> PT CAL OXYGENDEMAND <br /> PtA <br /> 40n e <br /> 40m1 VOA VIAL NK <br /> I'll <br /> 0nd VOA VIAL <br /> OT RPA 1664 <br /> T ODOR <br /> RADIOLOGICAL <br /> ACTERIOLOGICAL <br /> all VOA VLAL-4104 <br /> ffiA <br /> RPAS15 AMS <br /> ffiA 525 <br /> BPAS2 TRAVEL BLANK <br /> 40mi ffiA 547 <br /> 40ndRPAS3L I <br /> &=lCPAS48-- <br /> OT <br /> / <br /> A E49 <br /> OT RPA SUM <br /> OT BPA 8270 <br /> 8oa/6or/32as AMBRR <br /> 8wt/16oz/32or AR <br /> SOILSLEM <br /> Em VIAL. <br /> PL.ASITC BAG <br /> TEDLAR BA <br /> FERROXX IRON <br /> ENCORE <br /> $MART KIT <br /> SUMMA CANISTER <br /> :omments• <br /> rempie Numbering Completed By: Date/time: RW 21 06/23rA016 <br /> ® \-Actual / C s Corrected <br /> tsawmo°Awa�xr°caus_ EGe.20t <br /> The results in this report apply to the samples analyzed in accordance with the chain of custody 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: 1000620804 4100 Atlas Court Bakersfield,CA 93308 (661)3274911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />