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END <br /> Laboratories Inc. I.Itiul <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1402121 Page 3 of 3 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.No.15 07/01/13 Pae Of <br /> Submission#: '()a <br /> 9 _ <br /> 13 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Federal Express ❑ UPS❑ Hand Delivery Ice Chest- None ❑ Box ❑ <br /> BC Lab Field Serviced' Other❑ S eci ) YES ❑ NO ❑ <br /> ( P fY Other ❑(Specify) <br /> Refrigerant: ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seats Ice Chesf Containers❑ .r <br /> None Comments: <br /> Ali samples received? Yet;,Rll No❑ ' All samples containers intact? Ye&.12T� No❑ ' <br /> Descdption(si match COC? YeS�151,No ❑ <br /> COC Received Emissivity:�� Container:� Thermometer ID: ZZ(JD <br /> D YES ❑NO -26r-7 Datelrme 112 q- <br /> Temperature: (A) all 'C / (C ) D. ^C Analyst Init 9,7 <br /> r SAMPLE CONTAINERS SAMPLE NUMBERS <br /> 7 2 3 4 6 B 7 .8 <br /> f <br /> TGENERALMINERAUGENERAL a to <br /> PTPEUNPRESERVED <br /> T INORGANIC CHIMUCAL METALS <br /> PT INORGANIC CHEMIICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2oz NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT CH . <br /> PT C3IDhHCAi,OXYGENDEMAND <br /> PLA PHENOLICS <br /> 40m!VOA VIAL TRAVEL BLANK <br /> 40ra1 VOA VIAL (3) <br /> T EPA 413.1 433 4I8.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ail VOA VIAL-504 <br /> T EPA 508/608/8080 <br /> T EPA SIS.LSI50 - <br /> TEPA 52s - <br /> EPA 525 TRAVEL BLANK <br /> 100-1 EPA S47 <br /> 100nil EPA 531.1 <br /> TEPA 548 <br /> TEPA 549 <br /> T EPA 632 <br /> T EPA 8035M <br /> TAMBER <br /> 8 OZ.JAR <br /> 32 OZ JAR <br /> SOIL SLEEVE' <br /> PCB VIAL . <br /> PLASTIC BAG <br /> FERROUS DION <br /> ENCORE <br /> SMART KIT <br /> Summa Canister <br /> 'omments: <br /> Sample Numbering Completed Bv: <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 reportare for rhe 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.bclabs.com Page 5 of 28 <br />