Laserfiche WebLink
1 <br />1 <br />it <br />Laboratories, Inc. <br />Environmental Testing Laboratory Since 1949 <br />main of custody and Gooier Kecelpt Form for 1117340 Page 2 of 2 <br />BC LABORATORIES INC. SAMPLE RECEIPT FORM Rev. No. 12 06r24/0e rage _i r <br />Submission # 1 (+ Tjli D <br />SHIPPING INFORMATION SHIPPING CONTAINER <br />hest <br />Federal Express ❑ UPS ❑ Nand Delivery ❑ Ice C� None ❑ <br />Other ❑ (Specify) <br />BC Lab Field Service ," Other ❑ (Specify) Box <br />Refrigerant: Ice K Blue Ice ❑ None ❑ Other ❑ Comments: <br />Custody SealsEjntac!?�.Yesft <br />Containers ❑ None,4 Comments: <br />Intact? Yes No ❑ <br />All samples received? Y o ❑ All samples containers intact? No ❑ Description(s) match COC? Ye o ❑ <br />11COC ReceiveO Emissivity: O i 1 Container: \j Qq Thermometer ID:1 1 7 Date/Time !O \c1 11 3� <br />X� YES ❑ NO <br />,,..,.,,.e.A �.� °C / C �.� °C Analystinit ,labJ <br />Comments: <br />Sample NumbeNng Completed ey: DatelTime: S�S <br />A = ACtual I C = Corrected(H:WOCSlWP8eLLA6_DDCSIWRMSISAMRECZWPDj <br />The results in this report apply to the samples analyzed in accordance with the chain ojcustody 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, far 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 4 of 14 <br />