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Laboratories Inc. 0; <br /> 111- Environmental Testing Laboratory Since 1949 <br /> Chain of Custody and Cooler Receipt Form for 2128890 Page 2 of 2 <br /> KC LABORATORIES INC. COOLER RECEIPT FiDRM 13.42e Of <br /> Submission#_ 111 <br /> SHIPPING INFORMA71ON SHIPP IC CCh1TAIN:ft FREE 4[Qo l� <br /> Fed Ex -Z] UPS 13050 f GLS 11Ha rid Ocllvely ❑ Ice Cher None ❑ Bax r.l ❑ <br /> SC Lab Field Service 011ior❑(Spmify)� 'Other (Speglly). <br /> Rofrigaran#= to glue Ice 0 None EI Other 0 Conms6nts- <br /> CrlsEndy Seals lee chest❑ Elnt.ag? <br /> onfailterJs 0 Hon Comple-p#s; <br /> lnl417 Y"❑ Na❑ Yos i. NO Q <br /> Ail aampl"recmiw d7 Y No:I All saroplcs-;ggWinarl>Intact? Yes Nb C oeacrlpuen{s)match Cot? YMI;.R60 ❑ <br /> COC Received Ennis3ivity: = - con(slmer: l fhemmmeler to Deter<Trndl fii0 <br /> "If ES L7 N O Temperature: I A p - 0 l (C 'C Analys!IniE vV <br /> 5AMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> TPF.UNPRf-S <br /> 03tllWIfoa FSUkl'ltl;ti <br /> I ax LY" <br /> P <br /> GAMC CIIEMIrAL. 1�lJt CNEMICAS_METALS 4.xt phi iGEN F0MJ9 <br /> LSULPuIE <br /> 2oa t iTitAiv i NrrRrFE <br /> rl'TOTAi,{lEii Ar{1rr Ra(I'N <br /> FT1:llrlMlr. MA.`lL} <br /> PIA PHEM)DUCR <br /> OMI WO&VIAL TELkVF <br /> 46m1 VRA VJ4L <br /> OT EPA Id <br /> Jl.i]}IOJ�n,1 L <br /> e.4C. GlCAL <br /> EPA50Li 8.24M3a <br /> QT ffA 53EI HI SEA <br /> T S <br /> T RA7 gL.aLA�irL <br /> Lodi EPA I_S —.. <br /> £ax I=PA i-0LI <br /> i <br /> T FR7<LtpliM -- <br /> 1'VPA.21 <br /> Ma!1dokf L46 <br /> $n i az JAR <br /> Q 1'Y XQf-t <br /> P W <br /> FLA. G <br /> TEDLhR RA •—_ . <br /> FERROUS!a <br /> LN MME <br /> tMAC.1c.NE5TF.IK <br /> RT Krr <br /> C4111F7rcrll S• <br /> Sam*#fambering Complebed BY; 4akefTlrm., Ilur22 nan�rxt <br /> A=ftual C;C4rrericd <br /> [S.'MR_�oCAVuiRy LISV146pOG'JFORY6d NIRrCI�+JA¢ <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: 1001220099 4100 Atlas Court Bakersfield,CA 93308 (661)327-4911 FAX(661)327-1918 www.belabs.com Page 4 of 38 <br />