Employee Signature Register

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Laboratory Name:
MDH State Lab Code:
EPA Lab ID:
NPDES Permit Number (if applicable):
Employee Signature Register
Employee initials must be the same as the initials used on laboratory data. Please refer to
2009
TNI Standard, Vol 1, Module 2, Section
4.13.3, MN Rules 4740.2099.F, and 4740.2087 Subp.2.D.4
Employee Name (print):
Employee Signature
Initials
Date
_______________________________________________________________________________
Reviewer/Manager Name (print)
Reviewer/Manager Signature
Approval Date
Edited by MNELAP, 2013
Effective Date:

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