Schneider Laboratories, Inc.     Submitting Co.                 Lab Use-WO#    
  2512 West Cary Street, Richmond, Virginia 23220-5117                                
  804-353-6778 * 800-785-LABS (5227) * Fax 804-359-1475                         Acct #      
          www.slabinc.com          e-mail: info@slabinc.com                                  
Project Name                   Special Instructions [include requests for special reporting or data packages] Phone #      
Project Location                                                          
Project Number                                                   FAX #      
Purchase Order No.               STATE WHERE SAMPLES WERE COLLECTED_________________________    
                                                     
Turn Around Time Matrix / Sample Type (Select ONE) Tests / Analytes (Select ALL that Apply) ORGANICS TESTS and other Analyses
[  ] 6-8 hours*     All samples on form should be of SAME Asbestos Air / Fiber Counts Asbestos Bulk / Asb ID Metals-Total Conc.  NOTE:   All samples for organics should be kept at 4°C
[  ] 24 hours*   matrix type.  Use additional forms as needed. [  ] PCM (NIOSH 7400) [  ] PLM (EPA 600, 1993) [  ] Lead   from collection until testing.  Schedule rush analyses in
[  ] 48 hours*   [  ] Air [  ] Solid   [  ] TEM (AHERA) [  ] PLM (EPA Point Count) [  ] RCRA Metals   advance.        Indicate preservatives added & media type.
[  ] 72 hour*   [  ] Aqueous [  ] Waste   [  ] TEM (EPA Level II) [  ] PLM (Qualitative only) [  ] ________________________ Indicate analysis method for organics tests.
[  ] STANDARD (5 days) [  ] Bulk [  ] Wastewater   [  ] ____________________________   [  ] NYELAP 198.1/.4   [  ] ________________________________        
[  ] Standard Full TCLP (10d) [  ] Hi-Vol Filter (PM10) [  ] Water,Drinking Miscellaneous Tests [  ] CAELAP (EPA Interim) Metals-Total Conc.        
[  ] Weekend*   [  ] Hi-Vol Filter (TSP) [  ] Compliance   [  ] Total Dust (NIOSH 0500) [  ] TEM (Chatfield)   [  ] TCLP / Lead          
[  ] _____________________ [  ] Oil [  ] Wipe   [  ] Resp.  Dust (NIOSH 0600) [  ] _____________________ [  ] TCLP / RCRA Metals          
* not available for all tests [  ] Paint [  ] Wipe, Composite [  ] Silica - FTIR (NIOSH 7602) FOR ASBESTOS AIR: [  ] TCLP / Full (w/ organics)          
Schedule rush organics & [  ] Sludge [  ] _____________________ [  ] Silica - XRD (NIOSH 7500)  TYPE OF RESPIRATOR [  ] __________________________________          
weekend tests in advance. [  ] Soil     [  ] _____________________ [  ] ____________________________    USED: ___________________ [  ] ______________________________________                
  Organics     Wipes   Information for Air Samples Organics        
      Date   Sample Identification Wiped Type1 Time2 Flow Rate3 Total4 # con-          
Sample #     Sampled Time (e.g. Employee, SSN, Bldg, Material) Area (ft²) A,B,P,E Start Stop Start Stop Air Vol tainers