Laserfiche WebLink
c Laboratories Inc. <br /> ® Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717164 Page 2 of 2 <br /> Be LABORATORIES INC. COOLER R CEIPT FORM Page I Of <br /> Submission#: U <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS O Ontrac O Hand Delivery ❑ [as Chest 2 None ❑ Box O YES ❑ NO ❑ <br /> Be Lab Field Service 19 Other❑(Specify) Other ❑(Specify) W S <br /> Refrigerant: Ice fID' Blue Ice❑ None❑ Other❑ Comments: <br /> Custody SealshPp:: :" .. <br /> :. fae � None IN Comments: <br /> All samples received? Yes No O A0 samples contsi mm Intent? Yes 0 No❑ Description(s)match COC? YWj§ No O <br /> COC Received Emissivity: a Container. �)6A Thermometer ID:2_ Datelnms 2 Q <br /> ®YES ❑NO Tem erature: Al °C / C. -C' <br /> Anal Ink <br /> SAMPLE CONTAINERS SAMPLE NUMBERS <br /> 1 2 9 6 8 7 B e to <br /> YE UVPRES <br /> 4oz/Soz/I6oz PRUNPRW <br /> ZnCe, <br /> QT <br /> INORGANIC C EsuCAL METALS ._ i•�. <br /> ROORGAMCC—HEMCALb=ALS4oz/bxll6oz <br /> PT CYANIDE <br /> PT Nrl4tOGM FORMS <br /> PTTarALS iME <br /> 2= TR/NITRITS <br /> PT7QMORGAMCCARBON <br /> PTCMflCAL0XYGWDEMJ6JW <br /> 41knIVO&VULTRAVELKAM <br /> 40mt VOA VIAL <br /> OT RPA 2664 <br /> Pr ODOR <br /> RADIOLOGICAL <br /> "CrMUOWGICAL <br /> 0 ml VOA VIA4 SM <br /> ?tI <br /> $P S111=9 <br /> EPA SM <br /> EPA S26 TRAVEL.BLANK <br /> 40M EPA S47 <br /> 40mi EPA 533.1 <br /> Roz EPA S46 t <br /> T EPA$0 <br /> T EPA S025M <br /> OT EPA 6270 <br /> hoz/26=/ AMBER <br /> 26qz/33m AR <br /> SO <br /> PCB VL41 <br /> PLASTI BAG <br /> TWIAR BAG <br /> FERRO LRON <br /> .ENCORE <br /> SMART iar <br /> SUbM CANIRM <br /> :omments• <br /> ;ample Numbering Completed By: Date/17me: Rev 21 05MV2016 <br /> ® ►=Actual / C =Corrected lsamarwa _ 2W <br /> The results in this report apply to the samples analyzed in accordance with the chain ofcustody 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 parts interpretation. <br /> Report ID: 1000620664 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />