Chain Of Custody Record - Arl printable pdf download

Chain Of Custody Record - Arl

CHAIN OF CUSTODY RECORD

Company

___________________________ Date Results Required By:

Purchase Order Number:

(Please specify a time frame or number of working days)

Name

____________________________

SEND ALL REPORTS TO:

ARL Quotation Number:

Address

____________________________

(Please write in required email address, fax number, street address etc)

LABORATORY USE ONLY

_____________________________________

Payment Method

_____________________________________

SEND ALL INVOICES TO:

Cash/Chq.

Credit Card Inv (COD)

Phone

____________________________

(Please write in required email address, fax number, street address etc)

Inv (Acc)

Fax

____________________________

Receipt N

Invoice N

Comments

Analysis Required

ARL(WA)

LAB N

Sample Type

Sample ID

Container

(Water/Soil/Etc)

Received By:

Condition Upon Receival:

Date:

Time

(Server) Z:\docs\ARL Templates\CoC's and Job Sheets\Chain of Custody \Customer COC v5.doc

Date of Issue: 22 July 13

Chain Of Custody Record - Arl