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Laboratories Inc. 0; <br /> Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 2128888 Page 2 of 2 <br /> 6C LAE30 AYCFCEES INC_ CCDi_ER RECEIPT FORM Page Of <br /> submissii�n#: <br /> SHIPPING INFORMATION SHIPPING COWAI"EIt FREE IQVID <br /> Vod Ex ❑ UPS O GSO f Us Q Hand Delivery ❑ Ice Chas' Nano 0 Box 0 ❑ <br /> @C Lab Flefd Serviced OthEF ID{$pecify} 01lldr ❑ peci€y)__ <br /> Refrigerant; to Slue Ice 4 gone❑ Other❑ commernfs: <br /> Custody S12-AES 'Ice Chart n l'Oritainerg jj hlone �tTtima�Sta= <br /> In[aik't Yas G No Q Intid7 Yes_a ita O <br /> All SBinpks rcc+t3v0ad7 Yea q Mau All samples eonLainera intarA? 'cs\a No D EFoserEpGon{s)rnak h COGS Y-11�10 No o <br /> CDC ReceivedEmlaaavity_ Conia6ncr�� 7ltiernsorneiar Ip; peteFilm�l �f1 <br /> Q TLjhPmrmture. (A} -C ! f G } °G Analysllnit <br /> MAPLE NUIk96Rs <br /> SaprPi�40tfTFJNEFtS <br /> t s a e s a L 4 14 <br /> T FE ttNPAF4 <br /> 41* lJU 116oa Pk IJNPRB.S <br /> i <br /> ICUEEWCALUFT <br /> KNORC-h!'14C MRHICALMEEAUS46V 163E <br /> PT CYAAI <br /> rYten'ttorF S <br /> PTTDTA E <br /> xes NCTIRATElNIiR1Th <br /> O AL ORGAPi-C CAR8,Lm <br /> C,hl.O1LY{:Er;b M 4 <br /> Fill <br /> C3 <br /> CPnit VOA VLAJC1UY11&L ALAN PC <br /> V YL4L <br /> T r-PA 160a <br /> Pr 000ra <br /> gAaTo C[CAL <br /> > C_'MOLOGIrAL <br /> 40 E;' Vlal.rs[a <br /> TB�nsEora 0 jr4 <br /> Q'r ecPA 5ES,178lSiA <br /> £J'A SMZTLL h'PC <br /> R4. <br /> l EPA 5i7 <br /> A53]_] <br /> T EPA s urs <br /> t 5M <br /> SCA UR C <br /> ax tlfiFxt3 6$[{ <br /> fio¢!]5n ! JAR <br /> S[FIl:R R <br /> V A <br /> PLA. r <br /> TAnLARS <br /> TF.aROUS Trt <br /> ENCORE <br /> ShiARg]SI l' <br /> SOAiM CANISTER <br /> C"merm- <br /> Salrlplc Nurnbvxfng CornploEed DY- Datemme: xevss lr711r2t <br /> A=A�Iual � C�i~mrf�cfiea IxriAual�.o.ars.q�ri.ieyo:zuoaeyz,-4mk�wrep <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 we for the exclusive use of the submitting party. BC Laboratories,Inc.assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1001219295 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.belabs.com Page 4 of 55 <br />