Sample Chain of Custody Form

Customer Details:

Company Name (if applicable)

Full Name

Business or Residential Address

Phone Number

Email Address

This is where your results will be emailed

Sample Details:

Property address of where the sampling was conducted?

Which address or site did the samples come from?

Please complete the below. Ensure your sample bags are individually numbered with permanent marker with your name or company name:

Loyalty Discount Offer:

Leave us a Google Review and receive 10% off your invoice. Once submitted, please advise reception or by phone (02) 9008 0499 and enter your coupon code on checkout to apply your discount^. T&C's

^Discounts can only be applied to one job. A discount may only be received once. Once a coupon code has been issued, further coupon codes cannot be requested.

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Payment and Turn Around Time:

Choose one option below for how fast you require your sample results. ENSURE YOU ADD THE QTY. OF HOW MANY SAMPLES YOU HAVE SUBMITTED

STANDARD TAT (Slowest)

4 Business Day TAT

$95.00 AUD Sample Quantity
Item subtotal:

PRIORITY TAT (Fast)

2 Business Day TAT

$130.00 AUD Sample Quantity
Item subtotal:

URGENT TAT (Fastest)

Next Business Day TAT

$150.00 AUD Sample Quantity
Item subtotal:

Enter coupon

Subtotal

Tax

Total

Signature

Time

Sample Chain of Custody

Choose one option below for how fast you require your sample results. ENSURE YOU ADD THE QTY. OF HOW MANY SAMPLES YOU HAVE SUBMITTED*

Choose one option below for how fast you require your sample results. ENSURE YOU ADD THE QTY. OF HOW MANY SAMPLES YOU HAVE SUBMITTED