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ii <br /> Laboratories, Inc. 4 '. <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooter Receipt Form for 1219867 Page 2 of 3 <br /> lc LABORATORIES INC. COOLER RECEIPT FORM Rev.No.13 06117112 Page—A Of <br /> submission #:1a'AR <br /> SHIPPING INFORMATION HIPPING CONTAINER <br /> =ederal Express ❑ PS❑ Hand Delivery ❑ Ice Chest 9 None ❑ <br /> 3C Lab Field Service Other❑(Specify) Box ❑ Other ❑(Specify) <br /> Refrigerant: IceA Blue Ice❑ None ❑ Other❑ Comments: <br /> -ustody Seals Icer! <br /> Chest❑ Containers❑ Noned Comments: <br /> �. <br /> %11 samples received? Yes� No❑ All samples containers intact? Yes O• No❑ Descriptionls)match COC? Ye� No !❑ <br /> COC Received Emissivity:Q--15 Container:(V\1Fr— Thermometer ID: 0-1 Date/Time id(�sft2 <br /> dYES ❑ NO -C Analyst Init k� �( <br /> - Temperature: (A j l-� `C 1 �1 C j�� <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 7 2 3 4 5 6 7 8 9. 10 <br /> aT GENERAL MINERAL/GENERAL PHYSICAL . <br /> PT PE UNPRESERVED <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 1or_NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> PT CHENRCAL OXYGEN DEMAND <br /> PtA PHENOLICS <br /> 40m1 VOA VIAL TRAVEL BLANK <br /> 40m1 VOA VIAL <br /> T EPA 413.1.413.2.418.1 ...:. ..::.::. ._... <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> T EPA 508/608/8080 <br /> T EPA 515.1/8150 <br /> T EPA 525 <br /> T EPA 515 TRAVEL BLANK <br /> ]DOW EPA 547 <br /> 100m]EPA 531.1 <br /> T EPA 548 <br /> T EPA 549 <br /> 7 EPA 632 <br /> T EPA 801.-M <br /> OT AMBER FC- <br /> SOILSLEEVE aOZJAREEG32 OZ.JAR <br /> PCD VIAL <br /> PLASTIC BAG - <br /> TERROUSIRON <br /> ENCORE I <br /> gMA111.ix!) 1 <br /> Comments _p♦-{- <br /> 5rr:�!>!!t h!uml:rri!m Ci. :;�irfec E•, _fel __ DaelTirnu.:__._.�. _..—_. <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 parry.BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third patty interpretation. <br /> 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.bdabs.com Page 4 of 58 <br />