160 James Brown Drive Williston, Vermont 05495 Ph 802-879-4333 Fx 802-879-7103
CHAIN-OF-CUSTODY INSTRUCTIONS
The following instructions are provided to assist clients in accurately and completely filling out the Chain-of-Custody Record (C-o-C).
Underlined sections must be filled out
The Top Section of the C-of-C
“Project Name:”- Water supply systems use your WSID number. For Home water tests use your 911 assigned street address. “Reporting Address:”- Where you would like the report mailed. “Billing Address:”- For companies with an Endyne account only. Where you would like the bill mailed “Endyne Project Number”- For Laboratory use only!! “Company:”- Company name if applicable, at the least include a name and phone # the lab may contact if necessary. “Sampler Name”- Who collected the sample.
The Middle Section of the C-o-C, by the column
“Lab #”For Laboratory use Only!! “Sample Identification”- Sample specific collection site. Ex.: Kitchen Sink, Holding Tank, etc. “Matrix”- Type of sample. Ex.: Soil, Water, etc. “Grab/Comp”-Grab is sample taken at a specific instant.
Comp is when the sample is collected over an extended time. Ex: 8 hours, 24 hours “Date/Time”- When the sample was collected “Sample Containers”- The number and type of bottle the sample was collected in “Field Results”- Comments the sampler would like noted. Usually left blank. “Analysis Required”- The tests needed to be performed. You may reference a number code from below or just write the test in. You may use the space from “Field Results” or Box “30” below if necessary. “Sample Preservation”- Preservation techniques used for sample including refrigeration. “Rush”- Record the date you need results by, if sooner than 2 weeks.
The Bottom Section of the C-o-C, by the box
“Relinquished by: Signature”- Whomever delivers or ships the sample to the lab.
Very Top of Form Special Reporting Instructions - If you would like the report e-mailed or Faxed please make note of it on this line.
Revision: #3
Effective: August 23, 2005