Laserfiche WebLink
Laboratories Inc.—M 11. <br /> Environmental Testing Laboratory Since 1949 <br /> ® Chain of Custody and Cooler Receipt Form for 1219867 Page 3 of 3 <br /> BC LABORATORIES INC. ��,—} COOLER RECEIPT FORM Rev.No.13 08117112 Page d U1 v5 <br /> Submission #:l a� i7l <br /> q J 1 <br /> SHIPPING INFORMATION HIPPING CONTAINER <br /> Federal Express ❑ UPS❑ Hand Delivery ❑ Ice Chest None ❑ <br /> BC Lab Field Service Other❑(Specify) Box ❑ Other ❑ISpeci(yl <br /> Refrigerant: IceA Blue Ice ❑ None❑ ' Other❑ Comments: <br /> Custody Seals Ice Chest ❑ Containers.❑ None& Comments: <br /> i. i <br /> All samples received? 'Yes No❑ All samples containers intact? Yes f l No❑ Description(s)match COC? YeSA No ❑ <br /> �/ICOC Received EmissMty:O' jConttrainer: - Thermometer ID: l]� DatefTime <br /> hG'YES NO Temperature: (A) \•D `C l'Tc 1 0� "C Analyst(nit KI c <br /> 'SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> 1. 2 3 4 5 fi 7 8 9, t0 <br /> OT GENERAL MINERAL/GENERAL PHYSICAL _ <br /> PT PE UNPRESERVED <br /> T INORGANIC CBEMICAL METALS <br /> PT INORGANICCHEMICAL METALS <br /> PT CYANIDE . <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 30z NITRATE/NITRITE . <br /> PT TOTAL ORGANIC CARBON <br /> PT cHENaCAL OXYGEN DEMAND ' <br /> ® <br /> PIA PHENOLICS <br /> 40m1 VOA Wil.TRAVEL BLANK <br /> 40m1 YOA VIAL <br /> T EPA 413,L 413?,418.1 <br /> FT-ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40'ml'VOA VIA1,5044 <br /> T EPA 5081608/8080 <br /> T EPA 515.1/8150 <br /> TEPA 535 - <br /> T.EPA 525 TRAVEL BLANK <br /> IDD W,EPA547 <br /> 100ml EPA 531.1 ' <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 6333 <br /> T EPA 8013v1 <br /> T AMBER <br /> 8 OZ.JAR <br /> 32 OZ JAR <br /> SOL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> FERROUS IRON <br /> "F-NCDRE <br /> sm.4111 KIT <br /> Commenls: <br /> ® San'ple fd:rmbe,ing Cu...pieled By: Dare/Tin: <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 Iisted 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 58 <br />