Lead

Lead Chain of Custody Form

New York City Pb dust wipe projects: use the NY / NYC lead form instead of this one.

Ships to Union, NJIRIS Environmental Laboratories, 2333 US Highway 22 West. The label at the end carries this address and your code already.

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Job details

Anything we already know about your account is filled in.

Client name*

Phone*

Client address

City / State / Zip

Email*

Collected by*

Project address

Where the samples were collected, if that is not the client address. Your report is titled with it.

PO number

Turnaround time*

Do submitted dust wipe samples meet ASTM E1792 requirements?*

Yes No No dust wipes on this submission

Add a line for every sample in the box. Tap a line to open it.

The bag, the site, anything unusual. The camera is already in your hand and it gives the lab context.

Optional

Take a photo

This is the relinquished-by line from the paper form. It is what makes this a chain of custody.

Your name*

Email for the code*

I am releasing these samples to IRIS and I accept the terms and conditions.

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