Preservatives used;

Signature of persons involved in the chain of possession;

Inclusive dates and times of possession;

Internal temperature of shipping container when samples were sealed into the

container for shipping;

Internal temperature of container when opened at the laboratory; and

Remarks section to identify potential hazards or to relay other information to

the laboratory.

7.6.5

Sample Analysis Request Sheet

The sample analysis request sheet should accompany the sample(s) on delivery to the

laboratory and clearly identify which sample containers have been designated for each

requested parameter. The sample analysis request sheet may be included in, or be a part of,

the chain of custody record. The addition of preservatives should be noted on the sample

analysis request sheet. The sample analysis request sheet should include the following

information:

Name of person receiving the sample;

Name and addresses of analytical laboratory;

Laboratory sample number (if different from field number);

Date of sample receipt;

Analyses requested;

Internal temperature of shipping container upon opening in the laboratory; and

Preservatives added in the field.

November 1992

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