Chain Of Custody Form
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9000 Commerce Parkway, Suite B
Mount Laurel, NJ 08054
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Phone: 877-428-4285/856-231-9449
Fax: 856-231-9818
Chain of Custody
– Environmental Lead –
Contact Information
Client Company: ____________________________
Project Number: __________________________
Office Address:
____________________________
Project Name: __________________________
City, State, Zip: ____________________________
Primary Contact: __________________________
Fax Number:
____________________________
Office Phone: __________________________
Email Address:
____________________________
Cell Phone: __________________________
iATL is accredited by the National Lead Laboratory Accreditation Program (NLLAP) to perform analytical testing of
environmental samples for lead (Pb). The accreditation is through AIHA-LAP, LLC and several other nationally
recognized state programs.
Matrix/Method:
Paint by AAS: ASTM D3335-85a, 2009
Wipe/Dust by AAS: SW 846: 3050B: 700B, 2010
Air by AAS: NIOSH 7082, 1994
Soil by AAS: EPA SW 846 (Soil)
Water by AAS-GF: ASTM D3559-03D, US EPA 200.9
Other Metals (Cd, Zn, Cr) by AAS
Toxicity Characteristic Leaching Procedure (TCLP) by AAS: US EPA 1311
Other _________________________
Special Instructions:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Turnaround Time
Preliminary Results Requested Date: _________________________
Verbal
Email
Fax
Specific date / time
10 Day
5 Day
3 Day
2 Day
1 Day*
12 Hour**
6 Hour**
RUSH**
* End of next business day unless otherwise specified. ** Matrix Dependent. ***Please notify the lab before shipping***
Chain of Custody
Relinquished (Name/Organization): ___________________
Date: ____________ Time: __________________
Received (Name / iATL):
___________________
Date: ____________ Time: __________________
Sample Login (Name / iATL):
___________________
Date: ____________ Time: __________________
Analysis(Name(s) / iATL):
___________________
Date: ____________ Time: __________________
QA/QC Review (Name / iATL):
___________________
Date: ____________ Time: __________________
Archived / Released: ________QA/QC InterLAB Use: _____ Date: ____________ Time: __________________
Celebrating 25 years…one sample at a time
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