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— LabopatoYies Inc. � <br /> Environmerrtal Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 1400932 Page 2 of 3 <br /> BC LABORATORIES INC. COOLER RECEIPT FORM Rev.No.15 07/01113 Page Of 2— <br /> Submission <br /> Submission#: <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Ice Chest None ❑ Box ❑ YES ❑ NO ❑ <br /> Federal Express ❑ UPS❑ Hand Delivery Other ❑(Specify) <br /> BC Lab Field Service jT Other❑(Specify) <br /> Refrigerant' Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals lct 7f*e'Cfiest❑ None�3 Comments: <br /> . LEEND <br /> All samples containers intact? Yes ' No❑ Description(s)match COC? Yegd No ❑ <br /> AN samples received? Yes No❑ P <br /> OC Received Emissivity: 12Y-5— container. 1 LrlThermometer ID: �� Date/Tenel/3 Y 212f� <br /> 'El"YES ES ❑ NO Temperature: i A 1 '7 -C 1 (c 0. C <br /> Analyst Ink <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS2 3 4 5 6 7 a 9 10 <br /> � <br /> T GF.NERAI.MWERAI✓GIICERAL C— <br /> C <br /> C CSSMICAL METALS i <br /> PT INORGANIC CF9WCAL METALS <br /> PP CYANIDE <br /> PT MTROGEN PORMS <br /> Pr TOTAL SULFIDE <br /> tis NITRATEINITRITE <br /> PPTOTAL ORGANIC CARBON <br /> PP TO% <br /> PT CnEMiCAL OXYGEN DEMAND <br /> PIA PHFMUCS <br /> 4am1 VOA VIAL TRAVEL.BLANK 31 <br /> t3, 3. Pt tat <br /> 6-3 <br /> 40m1 VOA VIAL. <br /> QT EPA 413.L 4=418.1 <br /> Pr ODOR <br /> RADIOLOGICAL <br /> BACTWOLOEICAL <br /> 40 ml VOA VIAI,504 <br /> QT SPA saamomm <br /> QT EPA SM-M 50 <br /> _ QT EPA 575 <br /> QT EPA 525 TRAVEL BLAND <br /> 100m1 EPA 547 <br /> 100n3l EPA 53LI <br /> OT EPA 548 <br /> T EPA 549 <br /> OT EPA 632 <br /> T EPA 8015M <br /> T AMBER <br /> 8 OZ JAR <br /> 32 OZ JAR <br /> SOIL SLEEVE <br /> PCB VIAL . <br /> PLASTIC BAG <br /> FERROUSIRON <br /> ENCORE <br /> SMART%I1' <br /> Stirmma Canister -------------M� <br /> Comments: <br /> Sample Numbering Completed By: DatelTme: 1 205 <br /> .e.rmnnrsiwenlrreneentA6 oocstFotoasisamnEctst <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 patty.BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation- <br /> 4100 <br /> nterpretation4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 wwww.bciabs.com Page 4 of 59 <br />