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Laboratories IfZC. <br /> ® Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1717154 Page 2 of 2 <br /> BC LABORATORIES INC. COOLER R E(PT FORM Pae=L Of <br /> Submission#• <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ Ontrac❑ Hand Delivery ❑ Ice Chest 9 None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service 91 Other❑(Specify) Other ❑(Specify) W / S <br /> Refrigerant: Ice Ni' Blue ice❑ None❑ Other❑ Comments: <br /> Custody Seals d'. EiElt i7 2 c5failiers'&}- None 29 Comments: <br /> All samples received? Yes No❑ All samples containers intact? Yes No❑ Description(s)match COCT Yes No O <br /> COC Received Emissivity: 6.15 Container. Thermometer ID:209 DateffimmeQ <br /> ®YES ❑NO Tem ture: (A) 1C. •C Analyst Init <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> t 2 9 4 5 6 7 a 9 <br /> OT P$UNPRES <br /> 4oz/8ox/16os PEUNPRES <br /> 2oa r <br /> OTINO <br /> RGANIC METALS <br /> gNOsGANICCH=CALMRrALSQoz/ /16os Ci K -b e <br /> PT CYANIDE <br /> PT RMS <br /> PTTOTALSULIPIDR <br /> 2oa NITRATE/NrrRM <br /> PT TOTAL ORGANIC CARBON <br /> ® PT CHEMICAL OXYGENDEMAND e <br /> NA PHENOLICS <br /> 40nd VOA VIAL TRAVEL K AM <br /> 40m1 VOA VIAL ! <br /> OT EPA,1 <br /> PT ODOR ! <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ad VOA VLU,W4 <br /> OT EPA 5000811M <br /> EPASIL111 0 <br /> T RPA 52S <br /> QT IPA SBS TRAVEL BLANK <br /> 40nd EPA 54? <br /> 40ml EPA 53LI <br /> Boa IPA 548 t <br /> OT IPA 549 <br /> TEPA SBISM <br /> OT IPA 8270 <br /> Box/26ox/32ox AMBER <br /> Sm:/16oz/32ox JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLARBAG <br /> FERROUS IRON <br /> ENCORE <br /> SMART KIT <br /> SUMMA CANISTER <br /> :omments• <br /> ® ample Numbering Completed By: DateTme: Rev 2e 0e1221Ms <br /> g Actual / C -Corrected tsawroestwmarsttmatne ttooaratu4stsauascwra <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 party interpretation. <br /> Report ID: 1000620564 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 12 <br />