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—W Mail Laboratories Inc. <br /> Environmental Testing Laboratory Sing 1949 <br /> Chain of Custody and Cooler Receipt Form for 1214218 Page 2 of 2 <br /> 0 FFederal <br /> LABORATORIES INC- 1 COOLER RECEIPT FORM Rev,No.12 12iaot7o Page <br /> 101 L <br /> bmission #f: <br /> -14 <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Express ❑ UPS❑ Hand Delivery ❑ Ice Chesi.� None ❑ <br /> Lab Field Service CC Other❑(Specify) Box ❑ Other ❑(Specify) <br /> Refrigerant: Ice Blue ice❑ None❑ Other❑ Comments; <br /> Custody Seals=6h,,t Conia)ners 1:1 None 4 Comments: <br /> .I 1 <br /> in, <br /> No n <br /> All samples received? Ye No❑ AM samples containers intact? Yes No O Descripttii}on)s)match COC? Ye110 No <br /> 0 <br /> COC Received Emissivity: ©, O Container: IPI Thermometer ID: , f Date/Time <br /> [ YES 0 NO Temperature: i A) 1 {C 1 J g °C Analyst lnit <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> .i2 3 1 6 5 1 6 7 B 9 10 <br /> OT GENERAL miiitnU GENERAL PHYSICAL <br /> PT PE UATRESERVED <br /> T 0,1011GANIC CHEMICAL METALS <br /> Pr INORGANIC CFnht1CAL NIETA1S C' G <br /> I'T CYANIDE tt�� <br /> PT NITIIOCEN FOfmis °f <br /> Pr TOTAL SULFIDE <br /> 20 NITRATE I NITRn% <br /> r'T'rOT,AL ORGANIC CARBON <br /> PI'TOX <br /> FT CHEMICAL OXYGEN DENLBND <br /> PLA PHENOLICS Z <br /> 40ml VOA VIAL TRAVEL BLANK <br /> 40nd VOA VIAL l3 l3t i3t 3 "t3t P----:3, t t t t <br /> T EE'A Oil.i.413-'_,i18-I <br /> PT ODOR kk <br /> RADIOLOGICAL I <br /> BACTERIOLOGICAL I <br /> 40 ml VOA VLAL-504 <br /> T EPA 508/608/89M <br /> T EPA 515.118150 <br /> OT EPA 515 <br /> I <br /> T FPA 5i3 TRAVEL BLANK <br /> 100ml E11A 547 <br /> loom[EPA 5311 <br /> CIT EPA 548 <br /> OT EPA 549 <br /> 1 <br /> OT EPA 6L f <br /> OT EPA 8015;.] <br /> OT AN BE.R <br /> S OZ.JA It <br /> 3'OZ JA It <br /> SOI I_SLEECf_ <br /> PCB VIAL <br /> PLASTIC HAG <br /> FrItH01151110IN <br /> ENC OItL t <br /> Comments: <br /> Saaipfe Numbering Completed Dalemnie: <br /> A = caul 11 C = Correcietl <br /> iC^.b1rtYUCS.ve.,..n'e.I-M All.r,r ir:s.rmvi:;.:;r.rnen <br /> The results in this report apply to the samples analyzed in accordance with the chain ojcusiody document.This analytical report must be reproduced in its entirety. <br /> All results listed m 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 /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bdabs.com Page 4 of 36 <br />