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MoLogie Biotechnical Laboratory and Consulting Services SHEET OF <br /> Laboratory: 14025 Willow Creek Road, Ione, CA 95640 Ph. 209-245-4596 Fx. 209-245-3765 BIOLOGIC JOB# (Lab Only) <br /> CLIENT NAME/ADDRESS: (Send results to) PROJECT NAME/ID.: ANALYSIS REQUESTED <br /> Pertinent Information(by Client) <br /> SITE LOCATION: <br /> #of Containers <br /> PHONE FAX H Contaminant Type(s): Selective Medium <br /> CONTACT PERSON CLIENT PROJECT# Y 2. <br /> H S <br /> SEND INVOICE TO: PO# <br /> E S S I Estimated Nutrient Concentration/Range <br /> T E E C 1. 2• <br /> SAMPLED BY: (Print) E L L O Estimated Contaminant Levels/Range <br /> R E E C 1. 2. <br /> IATTN: o C C H Laboratory Project Manager: <br /> PHONE FAX T T T E ❑Ken Farrar <br /> V M R I I M 209-245-4596 Fx.209-245-3765 <br /> T <br /> MS : Net 30 Days R D O A O V V I ❑Marty Matinovich <br /> ,0imance charges of 1.5%per month on overdue Invoices) D D e E IG C L T P E E S 760-360-5251 Fx.760-345-0213 <br /> A d P R O U R H T ❑Richard Cavaliere (Lab Director) <br /> SAMPLE IDENTIFICATION!LOCATION Plate T O O T A M M I I # # R 209-245-4596 Fx.209-245-3765 <br /> (Typical Volume Required 500 ml water,8 ounce jar Soil) Using E x H B p E X C 1 2 Y <br /> 1 SPECIAL REQUEST/NOTES <br /> 2 (Special Treatment!Handling/Instructions) <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 10 <br /> RELINQUISHED BY Totals ■�ir♦►r •rirt• +fi• rtf• Standard microbial incubation is 6 days,unless shorter <br /> period is requested. <br /> Print Sign Date Time Received Date Time <br /> Standard Laboratory Turnaround Time is 8-10 days <br /> Physicochemistry summary worksheets can be reported <br /> PACKING INSTRUCTIONS To be Completed by Lab within 72-96 Hours,upon special request <br /> Please call Biologic staff for volume of sample necessary. No perservatives required. Ail Sample Recieved <br /> containers should be Glass(not plasic)or brass tubes. Samples should be placed in Ziploc Bags and Chilled Yes No ❑ Special TAT(Advise in Notes Section) <br /> individually insulated(bubble wrap)to eliminate breakage and leakage. Samples should be shipped on Intact Yes No <br /> ❑ <br /> Cold Packs(i.e.<Blue Ice)not ice within 24 hours via overnight carrier. Store samples in refrigerator if Broken/Chilled Special handling/Hold for future testing(Notes)Days Since Collection <br /> R delay in shipment is necessary. All coolers,cold packs,and excess sample will be returned via regular plating Concentration ❑Fax results to Above Number ' <br /> mail or courier freight collect. Disposal is$10 per sample if requested. Standard sample hold time is ❑Send Results regular mail <br /> F 14 days from date received, unless otherwise specified. ❑Fax Physicochemistry Report Rush(extra charge) <br /> fr._..i L . <br />