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Laboratories Inc. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1325148 Page 2 of 2 <br /> BC LABORATORIES INC. y COOLER RECEIPT FORM Rev.No.16 07/07/13 Page_L Of <br /> Subrnlssion #: 3. 0 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Federal Express ❑ UPS❑ Hand Delivery Ice Chest 91�' None ❑ Box ❑ YES ❑ NO ❑ <br /> BC Lab Field Service 01 Other❑(Specifyl Other ❑(Specify) <br /> Refrigerant: Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals +Ice1 l t-zC-t3n."'pe s None Comments: <br /> S. ,�t Rxf <br /> All samples received? Yes'lidNo❑ ' AB samples containers intact? Yes ' No❑ Description(s)match COC? Yes No ❑ <br /> COC Received Emissivity: IQ•G� Container. &t P4E Thermometer to: 20-7 Deterrime !f•I S•J3 2120 <br /> ,BYES ❑ NO <br /> Temperature* {A) •C C )—J.4 pC Analyst Inst S S <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> I 2 3 4 6 6 7 1 8 1 9 ib <br /> T GENERAL MINERAL/GENERAL <br /> PT PE i1NPRASERVED <br /> T INORGANIC C"MDCAL METALS <br /> PT INORGAMC CHENUCAL METALS C <br /> PT CYANIDE <br /> Pr NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2cc NTI7IATE I NITRITE <br /> PT TOTAL-ORGAMC CARBON' . <br /> PT TOX <br /> PT CH7IhIICA.L OXYGEN DEMAND <br /> PLA PHENOLICS <br /> 4009 VOA VIAL TRAVEL BLANK <br /> 40ml VOA VIAL. <br /> T EPA 413.1.41212,4111-1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 m1 VOA VIAL 504 <br /> OT EPA 508t608B080 <br /> T EPA 515.IA150 <br /> T EPA 5-23 <br /> T EPA 525 TRAVEL BLANK j <br /> 100mi EPA 547 i <br /> 100od EPA 53LI I ' <br /> I <br /> OT EPA 548 <br /> I <br /> T EPA 549 i <br /> OT EPA 632 <br /> T EPA 8015M <br /> T AMBER I <br /> 8 OZ JAR <br /> 32 OZ.JAR <br /> SOIL SLEEVEF, <br /> PCB VIAL <br /> PLASTIC BAG 33 <br /> FERROUS IRON I <br /> ENCORE <br /> SMART KIT <br /> Summa Canister <br /> :ommenis: <br /> ample Numbering Completed By: DateTme: <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 <br /> PPY P � <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 /> 4100 Atlas Court Bakersfield,CA 93308 (661)3274911 FAX(661)327-1918 www.bciabs.com Page 4 of 28 <br />