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i A-7 5 1 4 Chain-of-Custody Record A chain-of-custody record will be filled out for and will accompany every sample and every shipment of samples to the analytical laboratories in order to establish the documentation necessary to trace sample possession from the time of collection The record will contain the following information • Sample or station number or sample I D • Signature of collector, sampler, or recorder • Date and time of collection • Place of collection • Sample type • Signatures of persons involved in the chain of possession • Inclusive dates of possession The laboratory portion of the form should be completed by laboratory personnel and will contain the following information • Name of person receiving the sample • Laboratory sample number • Date and time of sample receipt • Analyses requested • Sample condition and temperature S 1 5__Sample Transfer and Shipment Samples will always be accompanied by a chain-of-custody record When transferring samples, the individuals relinquishing and receiving the samples will sign, date, and note the time on the chain-of-custody record Samples will be packaged properly for shipment and dispatched to the appropriate laboratory for analysis The chain-of-custody record will accompany each shipment. The method of shipment, courser name(s), and other pertinent information will be entered an the chain-of-custody record 5,2 Laboratory Custody Procedures A designated sample custodian will accept custody of the shipped samples and verify that the information on the sample label matches that on the chain-of-custody record information regarding method of delivery and sample conditions will also be checked on the chain-of-custody record. The custodian will then enter the appropriate data into the laboratory sample tracking system The laboratory custodian may use the sample number on the sample label or may assign a unique laboratory number to each sample The custodian will then transfer the sample(s) to the proper analyst(s) or store the sample(s) in the appropriate secure area