Chain-Of-Custody / Analytical Request Document (Page 2 of 2) in pdf

Instructions for completing Chain of Custody (COC)

1. Section A and B: Complete all Client information at top of sheet: company name, address, phone, fax, contact (the person to contact if there are

questions, and who will receive the final report.), e-mail address (if available), PO#, Project Name and/or Project Number as you would like to see it

appear on the report.

2. Section C: Invoice Information: Billing information is included in this section. This information should include the name and address of the person

receiving the invoice.

3. Quote Reference should be completed if a quotation was provided by Pace Analytical. The Project Manager, and Profile No. will be completed by

Pace Analytical Services.

4. Site Location: A separate COC must be filled out for each day of sample collection. Record the two letter postal code for the US state in which the

samples were collected.

5. Regulatory Agency: List the program that is guiding the work to ensure proper regulations are followed.

6. Section D: Complete a Sample Description in the “SAMPLE ID’ section as you would like it to appear on the laboratory report. The following

information should also be included: the sample matrix, sample type (G (grab) or C (composite). When collecting a composite, the start time and end

time should be documented in the respective boxes. The collection time for a grab (G) sample should be entered in the boxes marked ‘Composite

End/Grab’), Sample temp at collection (if required by state), the total number of containers, and preservative used.

7. Mark if the sample was filtered in the field by marking Y or N in ‘Filtered’ row by the Analysis requested.

8. Requested Analysis: List the required analysis and methods on the lines provided and place a check in the column for the samples requiring the

analysis. Additional comments should be referenced in the bottom left hand corner or include attachments for extended lists of parameters.

9. The sampler should print their name in the space provided and sign their name followed by the date of the sampling event at the bottom of the COC in

the spaces designated for ‘SAMPLER NAME AND SIGNATURE’.

10. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate the Item Numbers of those samples

being transferred; sign relinquished by, date and time, and include your affiliation.

*Important Note:

Standard Turnaround Time is 2 Weeks/10 business days. Results will be delivered by end of business on the date due unless other arrangements

have been made with your project manager.

Special Project Requirements such as Low Level Detection Limits or level of QC reported must be included on the chain of custody in the Additional

Comments section.