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m <br /> aceAna/ytica/ <br /> ENVIRONMENTAL SCIENCES <br /> Chain of Custody and Cooler Receipt Form for 2602031 Page 3 of 6 <br /> PACE ANALYTICAL COOLER RECEIPT FORM Page Of <br /> Submission#: 16(?2 0 <br /> SHIPPING INFORMATION SHIPPING CONTAINER FREE LIQUID <br /> Fed Ex ❑ UPS❑ - GSO/GLS❑ Hand Delivery ❑ Ice Chest None ❑ Box ElYES pd NO ❑ <br /> Pace Lab Field Service Other❑(Specify) Other ❑(Specify) Ay <br /> S <br /> Refrigerant: Ice Blue Ice❑ None❑ Other❑ Comments: <br /> Custody Seals Ice Chest❑ Containers❑ - None Comments: <br /> Intact?Yes,0 No]❑ Intact?Yes❑-No C] / <br /> All samples received? Yes V No❑ All samples containers intact? Yes til' No❑ Description(s)match COC? Yes No ❑ <br /> COC Received Emissivity: 0•94 Container: N ThermometerlD: 3cl� Date/Time 9 II&C, <br /> YES ❑NO Temperature: (A) °C f (C ) i °C Analyst Init I'I <br /> SAMPLE NUMBERS <br /> SAMPLE CONTAINERS <br /> ) i 12 3 1 i4 I Z.4 6 117 8 9 1 10 <br /> T PE UNP ES <br /> 4oz/Bar 16oz E UNPRES f L I' 1' T—L <br /> 2oz Cry -- <br /> T INORGANIC CHEMICAL METALS <br /> INORGANIC CHEMICAL METALS 4oz!8oz/16oz _— <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PTTOTALSULFIDE -�• <br /> 2—NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT CHEMICAL OXYGEN DEMAND <br /> PtA PHENOLICS <br /> 40.1 VOA VIAL TRAVEL BLANK <br /> 40m1 VOA VIAL <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAL-504 <br /> T EPA 5081608.3/8081A <br /> QT EPA 515.118151A <br /> T EPA 525.2 ys' <br /> T EPA 525.2 TRAVEL BLANK -- <br /> 40mI EPA 547 -- <br /> I <br /> 40m1 EPA 531.1 —� <br /> 8az EPA 548.1 <br /> T EPA 549.2 ----- ----i <br /> T EPA 80ISM -- — <br /> T EPA 8270C --.— <br /> 8oz/16ozl32oz AMBER --� <br /> 8oz/16oz!32oz JAR NM SS <br /> SOIL SLEEVE r <br /> PCB VIAL <br /> PLASTIC BAG <br /> TEDLAR BAG I - <br /> FERROUS IRON Iii+ <br /> ENCORE ----� <br /> SMART KIT ... 'I <br /> SUMMA CANISTER <br /> Comments: - <br /> Sample Numbering Completed By: C L'_ Daterrime: L _ Rev 23 9512CU <br /> A=Actual 1 C=Corrected lsaPmoxwam.naac.ne oocsu:ol:xsvcwiazc�e.zol <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 party. Pace Analytical assumes no responsibility for report alteration,separation,detachment or third party interpretation. <br /> Report ID: 1001665034 4100 Atlas Court Bakersfield, CA 93308 (661)327-4911 FAX(661)327-1918 www.pacelabs.com Page 7 of 147 <br />