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® �f���r!e�� c. Id' <br /> nce 1949 <br /> Chain of Custody and Cooler Receipt Form for 1907001 Page 2 of 2 <br /> F18CABO AT FUEs COOLER RECEIPT FORM Page Of <br /> mission#: SHIPPINt3 I�IFORMATiOA1SHIPPI CONTAINER FREE LIQUID <br /> Ex UPS® Ontrac D Hand Delivery ❑ Iola Chest None ❑ Bax ❑ yE ❑ NO O <br /> Lob d Service ❑ Other❑(Spec9ty Other ❑Ispe 'yk <br /> W f $ <br /> Refrigerant: Ice Blue Ice 0 Norbe❑ Other❑ menu: <br /> Custody Seats 1 CIIet' Gistttainere 0 <br /> None ComtnentB: <br /> AM smipliti,recabran Yes t44 AR sa s oentdl rs h,%CI? Yes If' No Q DescrIptlo®(a)ur.tch COC? Yes;Gf No 13 <br /> Received E Ivlty: tamer: Thermometer lo: t?at.tTime <br /> d C <br /> YE$ ❑NO Temperature (A �, <br /> °C °C Anolyst Inli <br /> SAKKE CONTAINERS SAMPLE NUMBERs <br /> a <br /> UNPRES <br /> 1 NIC ALMB7'A <br /> ANt ec•Ac srAts r .t 18aot <br /> Crmm�a <br /> Pr Gtte s <br /> UL NtTAA tNWAIt7e <br /> TO9•AL OR CCARNM <br /> Pr /CAL 0A'VC7 1FWMA <br /> e1A ca <br /> VOA ALTRAVULBLANK <br /> 4 mt VOA VIAI. <br /> Pr <br /> RA. ICAL <br /> BA 1AGICAL <br /> 40.d YOA h <br /> A <br /> A 515.NISO <br /> CITEPAS25 <br /> or <br /> Ird°A 1°CI.Bt.ANK <br /> 40mt RP 347 <br /> A$31.3 <br /> A$43 <br /> A$49 <br /> A dOIS <br /> T CdA ffi2 <br /> a1r <br /> Boz 116x1 Zu AR <br /> SOIL <br /> `'IAL <br /> P' C DAG <br /> TE BAG <br /> RROIN Leo d <br /> ENCOM <br /> KT Kff <br /> CANISTER <br /> Comments- <br /> saoytpm NumbAS Completed By: e1 tom: <br /> A=Act l I C-Corrected acro zW oWZW1'et@ <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 party interpretation. <br /> Report ID: 1000861040 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bclabs.com Page 4 of 35 <br />