IH CHAIN OF CUSTODY
* Emergency TAT requires prior lab notification. All samples analyzed outside normal business hours are charged at Emergency rate.**TAT’s are in Business Days rather than Hours (i.e.1 Day TAT = End of Next Business Day)
Submitter Name: Bill to:
Company: Address:
Address:
City/State: Zip:
City/State: Zip: PO #: Project Information
Project Name: Project Manager:
Project #: Telephone – Office/Cell
Reports - Email Address:
Invoice - Email Address: Notification By: Email: Verbal:
Special Instructions:
Turnaround Times – Please Select One
Emergency* 1 Day 2 Day 3 Day 5 Day ASBESTOS
PLM - Bulk PCM - Air TEM - Air TEM - Bulk TEM - Water TEM - Dust TEM/PLM Soil/Vermiculite/Ore
EPA 600/R-93/116o Visual Estimation (<1%)
o 400 Point Count 0.25%
o 1,000 Point Count 0.1%
o Gravimetric Reduction
o Matrix Reduction (+/-)
o NIOSH 9002o OSHA ID-191
o NIOSH 7400o ASTM D7201o ISO 8672o OSHA ID-160
o AHERA o NIOSH 7402 o ASTM D6281 o ISO 10312 o ISO 13794
o GravimetricReduction (<1%)
o MatrixReduction (+/-)
o Qualitative (+/-)o Drop Mounto Filtration
o EPA 100.2 Drinking Water o >10 µm fiberso ≥0.5 µm fibers
o EPA 100.2 Effluent / WW
o ASTM D5755Microvac
o ASTM D6480Wipe
o 600/J-93/167Carpet - EPA
o Bulk DustQualitative
o ASTM 7521-TEM (+/-)
o ASTM 7521-TEM (<1%)
o CARB 435-Modified
o Soil – PLM Only (+/-)
o Vermiculite - TEM (+/-)
o Vermiculite-Cincinnati
o Erionite ID
METALS SILICA/PARTICULATES
Flame AA Graphite Furnace AA -
LEAD ICP X-Ray Diffraction / Gravimetric
o Lead in Paint – SW846 7420/3050B o Drinking Water – EPA 200.9 o Elements in Air – NIOSH 7300o Lead in Air – NIOSH 7082 o Wastewater – SW846-7421 o Wipe/Soil – SW846-6010B
o Respirable Crystalline Silica NIOSH 7500 / OSHA 142
o Lead in Wipes – SW846 7420/3050B o Soil/Sludge – SW846-7421 o Effluent – SW846-6010Bo Lead in Soil – SW846 7420/3050B o Air – NIOSH 7105 o Welding Fume – NIOSH 7300M
Total Number of Samples Submitted: Positive Stop: YES NO Signatures
Relinquished By: Date: Time:
Received By: Date: Time:
Relinquished By: Date: Time: Received By: Date: Time:
J3 Order # (Lab use only) Open Lab Fee
o NIOSH 0500 – Total Particulates
o NIOSH 0600 – Respirable Particulateso TCLP – SW846-1311/6010B
Eurofins J3 Resources, Inc. 6110 West 34th Street Houston, Texas 77092 tel: 713-290-0221 fax: 713-290-0248 Eurofins J3 Resources, Inc. 3113 Red Bluff Road Pasadena, Texas 77503 tel: 713-290-0223 fax: 713-290-0248
Received on ice:
Temp: _________
Page ____ of ____
Revision #v7/MF Revision Date: 3/09/2020
Yes Noo o
IH CHAIN OF CUSTODY Project Name ______________________________________________
Page ____ of ____SAMPLE IDENTIFICATION
SAMPLE NUMBER SAMPLE LOCATION / MATERIAL VOLUME/CONDITION
Comments/Special Instructions:
Revision #v7/MF Revision Date: 3/09/2020
Eurofins J3 Resources, Inc. 6110 West 34th Street Houston, Texas 77092 tel: 713-290-0221 fax: 713-290-0248Eurofins J3 Resources, Inc. 3113 Red Bluff Road Pasadena, Texas 77503 tel: 713-290-0223 fax: 713-290-0248
Project Number ________________
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