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
Format: (000) 000-0000.
PO
Shipping Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 1)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 2)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 3)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 4)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 5)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 6)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 7)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 8)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 9)
- * 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
  2 digit month, 2 digit day, 4 digit yearDate
- Is this a RUSH sample? (Sample 10)

Chain of Custody Record

Client Information

Sample Registration

Sample