Chain of Custody Record

Items marked with * are required for registration.
Chain of Custody Record
Notes:

Information can be found in your BeSafer Account

Email to:

Logistics@agqlabs.com

Send to:

AGQ Labs

Attn: Logistics 2451 Eastman Ave. STE 1, Oxnard CA 93030

P. +1 (805) 981 - 2972

E. customerservice@agqlabs.com
Client Information
Client Code*
Client Name*
Client Address*
(X3) Address*
Quote No.*
Requested By*
Email*
example@example.com
Sampled by
Phone*
PO
Shipping Date

MonthDayYear
Date
Sample Registration
- Items with * must be filled out
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 1)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 2)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 3)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 4)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 5)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 6)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 7)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 8)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 9)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.
- * Analysis Code
- * Sample Type
- * Sample Description
  Internal Sample ID, variety of commodity, etc. (Will appear on report header & invoice / 116 Character Max)
- Lot Number
- Notes
  Example: grower, blokc, sampling site, etc.
- Sampling Date
  
  MonthDayYear
  Date
- Is this a RUSH sample? (Sample 10)
  
  NoYes, I agree on paying a 50% Fee of the standard price for the analysis.

Chain of Custody Record

Client Information

Sample Registration

Sample