SPL Sample Kit Request Form

ALL FIELDS BELOW MUST BE FILLED OUT!

SHIPMENT INFORMATION:
Laboratory:

Company:
Contact:
Street:
City
State: Zip:
Phone:     Fax:
Email Address:
Kit Requested By:
Today's Date: Date of Start of Project:
Date Kit Delivery Needed:

Turnaround Time Requirements:

  
10 Day Turnaround Time
5 Day Turnaround Time (Standard for some tests)
4 Day Turnaround Time
72 Hour Turnaround Time
48 Hour Turnaround Time
24 Hour Turnaround Time
   

State Work is Being Performed In:

    Other:

Data Deliverables:

  
Stanadard Level II Report
Level III Report
Level IV (CLP Like) Report
TCEQ TRRP Report      TRRP Raw Data Required
RECAP       New Jersey Deliverables
 

ANALYSIS REQUIRMENTS:
Analysis

Method

Matrix

# of Samples

 

 

 

 

 

 

 

 

 

 

 
 
Do you need Trip Blanks Quantity
 

VOC Samplers:
Sampler Type

Quantity Needed
5 Gram Encore

 
25 Gram Encore

 
Encore T Handle

 
Terra Core Kits*

 
5035 Kits -Bisodium Sulfate

 
*Kit includes 3 preserved container & 1 unpreserved container.

ALL FIELDS MUST BE FILLED OUT!

Please contact me as soon as possible.

Copyright © 2005 [SPL, Inc.]. All rights reserved.
Revised: 08/12/08.

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