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Laboratories Inc. <br /> ® Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Foran for 1717149 Page 2 of 2 <br /> [All <br /> LABORATORIES INC. COOLER ®PT FORM Pae Of <br /> bmission#•171 L-1 lycj <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest IB None ❑ Box ❑ YES ❑ NO ❑ <br /> Lab Field Service Other❑(Specify). Other ❑(Specffy) W $ <br /> frigerant: Ice 5' Blue Ice❑ None❑ Other❑ Comments: <br /> tody Seals t .G,fxs t 7 _5 .¢gA t4iltsr613. None St Comments: <br /> amples received? Yes No O All samples containers intact? Yes No O Descriptions)match COC? Yes No ❑ <br /> COC Received EmisslvkY: a Contahter_ Thermometer it):20B_ DateMme <br /> ®YES 0 NO Temperature: (A) °C 1 C. ^C Analyst Ink <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1 z a a a e 1 7 a a 10 <br /> T PR UNPRBS <br /> 4oz/8=/16oz PRUNPRFS <br /> 2oa Ce' <br /> OT WORGAMCCIUMCALNNULS ._ ...- --- <br /> lN CHMCAL858TALS4oa/aos/16os K 13 DSTRIBUI TION <br /> PT OLAMDE <br /> PT NITROGW FORMt? <br /> PT TOTALSUUWE <br /> 2o.NITRATE/NITRPrR <br /> PT TOTAL RGANIC CARBON <br /> ® PT CMUC&L O%YGffia D <br /> PIA.YBlUVOLICS <br /> 40nd VOA VIAL. BLANK e <br /> 40ml VOA VIAL <br /> RPA 1665 <br /> PT ODOR <br /> RADIOLOGICAL <br /> RACURIOLOGICAL <br /> 40 ud VOA VIAL-504 <br /> TEPA 80 <br /> SPA SIS.1AM ,t .. <br /> OT SPA S5 <br /> EPA 525 TRAVSL BLANK: <br /> 4W EPAW <br /> 4WEPA53LI <br /> SnRPA S48 t <br /> CrIPASO <br /> OrEPAUM <br /> OT EPA 8810 <br /> /1M/32a AMBER <br /> /16oa/32oz JAR <br /> SLEEVE <br /> PLASITCRAG <br /> TRDLAR BA <br /> FERR USIRON <br /> &Hoon <br /> SARARTRiT . <br /> St$MNA CANISTIiR <br /> :omments• <br /> lampte Numbering Completed By: Daterrime: ear 21 05rM=16 <br /> 1=Actual / C a Corrected tSiIWPDodW*Vt�ramue_DOCWOMUWAMRECm2m <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 parry interpretation. <br /> Report ID: 1000620599 4100 Atlas Court Bakersfield,CA 93308 (661)327.4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12. <br />