EMSL | 2020 Inspection Solutions

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Mold & Water Test

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Asbestos

Asbestos COC

Asbestos Chain of Custody (Air, Bulk, Soil)

Project Name/No:

Sampled By Name:

No. of Samples in Shipment

Date

Time

Turn Around Time

3 Hour

6 Hour

24 Hour

48 Hour

Other Test (please specify)

Positive Stop - Clearly Identified Homogeneous Areas (HA)

Filter Pore Size (Air Samples)

0.8 um

0.45 um

Sample 1 Number

Sample 1 Location / Description

Sample 1 Volume, Area or Homogeneous Area

Sample 1 Date Sampled (Air Monitoring Only)

Sample 1 Time Sampled (Air Monitoring Only)

Sample 2 Number

Sample 2 Location / Description

Sample 2 Volume, Area or Homogeneous Area

Sample 2 Date Sampled (Air Monitoring Only)

Sample 2 Time Sampled (Air Monitoring Only)

Sample 3 Number

Sample 3 Location / Description

Sample 3 Volume, Area or Homogeneous Area

Sample 3 Date Sampled (Air Monitoring Only)

Sample 3 Time Sampled (Air Monitoring Only)Time

Sample 4 Number

Sample 4 Location / Description

Sample 4 Volume, Area or Homogeneous Area

Sample 4 Date Sampled (Air Monitoring Only)

Sample 4 Time Sampled (Air Monitoring Only)

Sample 5 Number

Sample 5 Location / Description

Sample 5 Volume, Area or Homogeneous Area

Sample 5 Date Sampled (Air Monitoring Only)

Sample 5 Time Sampled (Air Monitoring Only)

Sample 6 Number

Sample 6 Location / Description

Sample 6 Volume, Area or Homogeneous Area

Sample 6 Date Sampled (Air Monitoring Only)

Sample 6 Time Sampled (Air Monitoring Only)

Sample 7 Number

Sample 7 Location / Description

Sample 7 Volume, Area or Homogeneous Area

Sample 7 Date Sampled (Air Monitoring Only)

Sample 7 Time Sampled (Air Monitoring Only)

Sample 8 Number

Sample 8 Location / Description

Sample 8 Volume, Area or Homogeneous Area

Sample 8 Date Sampled (Air Monitoring Only)

Sample 8 Time Sampled (Air Monitoring Only)

Microbiology

Microbiology COC

Mold Chain of Custody Form

Project Name/No:

Zip Code

Number of Samples:

Sampled By Name:

Relinquished Date

Relinquished Time

Turn-Around-Time

3 Hour

6 Hour

24 Hour

48 Hour

72 Hour

Received on Ice? Check if Yes:

Serial # 1

Sample 1 Location

Sample 1 Type

Sample 1 Potable / Non-Potable (Only for Water)

Sample 1 Test Code

Sample 1 Volume/Area

Sample 1 Date

Sample 1 Time

Sample # 2

Sample 2 Location

Sample 2 Type

Sample 2 Potable / Non-Potable (Only for Water)

Sample 2 Test Code

Sample 2 Volume/Area

Date

Time

Serial # 3

Sample 3 Location

Sample 3 Type

Sample 3 Potable / Non-Potable (Only for Water)

Sample 3 Test Code

Sample 3 Volume/Area

Date

Time

Serial # 4

Sample 4 Location

Sample 4 Type

Sample 4 Potable / Non-Potable (Only for Water)

Sample 4 Test Code

Sample 4 Volume/Area

Date

Time

Serial # 5

Sample 5 Location

Sample 5 Type

Sample 5 Potable / Non-Potable (Only for Water)

Sample 5 Test Code

Sample 5 Volume/Area

Date

Time

Serial # 6

Sample 6 Location

Sample 6 Type

Sample 6 Potable / Non-Potable (Only for Water)

Sample 6 Test Code

Sample 6 Volume/Area

Time

Date

Water FHA/VA

Water FHA/VA COC

Drinking Water Chain of Custody

Project Name/No:

Sampled By Name:

No. of Samples in Shipment

Date

Time

FHA/VA Basic Water Panel

Total Coliform, E. coli , Lead, Nitrate, Nitrite, Turbidity

Exclude Turbidity from Lab Report

FHA/VA BasicPlus Water Panel

Total Coliform, E. coli , Lead, Nitrate, Nitrite, Turbidity Plus: Iron, Manganese, pH

Exclude Turbidity from Lab Report

Sampling Site (Please fill all bottles from the same drinking water outlet)

Date Collected

Time Collected

Lead

Lead COC

Lead testing chain of custody form

Project Name/No:

Sampled By Name:

No. of Samples in Shipment

Date

Time

Turn-Around-Time (TAT)

3 Hour

6 Hour

24 Hour

48 Hour

72 Hour

Sample Number 1

Sample Location 1

Volume / Area 1

Date Sampled 1

Time Sampled 1

Sample Number 2

Sample Location 2

Volume / Area 2

Date Sampled 2

Time Sampled 2

Sample Number 3

Sample Location 3

Volume / Area 3

Date Sampled 3

Time Sampled 3

Sample Number 4

Sample Location 4

Volume / Area 4

Date Sampled 4

Time Sampled 4

Sample Number 5

Sample Location 5

Volume / Area 5

Date Sampled 5

Time Sampled 5