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Laboratories <br /> E �Lab <br /> tory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1402120 Page 3 of 3 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.No.15 071011[3 Page Of <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREErLIQUID <br /> Federal Express 0 UPS 0 Hand Delivery lee Chest-le None 0 Box Ej YES 0 NO 0 <br /> BC Lab Field Service. <br /> Other 0(Specify) Other 0(Specify) <br /> Refrigerant: Iced Blue Ice 0 None[I Other 0 Comments: <br /> V Comments: <br /> Custody Seals Non,r <br /> AD samples received? Yea Ut No 0 All samples containers intact? Yes'p-pr'No 0 Description(s)match coc? YeFM No El <br /> COG Received E-1-hritir: Container: J� Thermometer ID: 20-1 Datefrime ftig- <br /> ES 0 NO <br /> f Temperature: (A) 419 -C / (C 0 C Analyst Init �91? <br /> Comments: <br /> Comments: <br /> D--c'i <br /> r <br /> COM <br /> �LN T t2 <br /> hemr.mete ID- <br /> (C ) 0. <br /> SAMPLE CONTAINERS SAMPLE NUMBERS <br /> 9 10 <br /> TGEANTEARIALLMINE AU GENERAL <br /> V-- � =;;. <br /> ,VfPEUNPRMRVED <br /> W1T INORGANIC CHEMICAL METALS <br /> 1'r INORGANIC CHIMUCAL METALS <br /> PT CYANIDE <br /> T'NORGANIC�� <br /> 'rIN0G <br /> INORGANIC <br /> PT NITROGEN FORMS <br /> ' 7 <br /> PT TOTAL SULFIDE <br /> 2oL RATE/NrrRrm— <br /> PT <br /> Pr TOTAL ORGANIC CARBON <br /> LiPT TOX <br /> PT <br /> PT CHEMICAL OXYGEN DEMAND <br /> PHENOLICS <br /> PIA EEEE I <br /> m]VOA VIAL TRAVEL BLANK <br /> [E-W-VOA VUL lk-.31 <br /> 31 A 131 <br /> �QT EPA 413.1,413J.418.1 <br /> [MODOR j <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 3W VOA VIAJ-SO4 <br /> RP _ " , <br /> T EPA SlIS/609ago <br /> T RPA 1...IM <br /> EPA 525 <br /> rT <br /> E-PA 525 TRAVEL BLANK <br /> 100m1 EPA 5147 <br /> —ml EPA 53LI <br /> OT EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 80L5M <br /> TAMBER <br /> 8 07-JAR <br /> 32 0&JAR <br /> 11SOILSLEEVE" <br /> 11PCB VIAL <br /> PLASTIC RAG <br /> FERROUS IRON <br /> ENCORE <br /> SMART KIT <br /> Summit Canister <br /> Comments: <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 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 5 of 43 <br />