EAL Sample Submittal Form

Please if a paper copy is desired please print out form before hitting submit button.  

A copy of this form will be sent to the e-mail address entered in this form.

A copy of this completed form will be sent to the e-mail address entered here.

Sample Information

For main sample collected such as method 1623 or MPA. No method specification is needed.

Requirements for Method 1623: Need at least 10 liter or 2.65 gallons sampled and must arrive at lab at or below 20°C and arrive at within 48 hour plus 48 hours for lab processing for a total time of 96 hours.

Requirements for MPA: Need at least 500 gallons sampled and must arrive at lab at or below 3°C and arrive at within 48 hour.
Not the Main Sample time but an add on time for EPA LT2 Clients.
Requirements for Receipt of E.coli: Must arrive at lab at or below 10°C and arrive at within 29 hour plus hour for lab processing for a total time of 30 hours.
E. coli collection notice: Fill bottle to 100ml marking and make sure lid is screwed tighly!
E. coli Shipping Note: Clear polystyrene collection bottles need a bubble pack bag for shipping and opaque polypropylene bottles do not.
Filter Information
For Grab Samples - we need the collection time recorded at the "Start Time" field below.

Use for Grab Samples Too.
Example - Biosolids
* Required for Ohio Clients USE THE NUMBER ZERO, IF ONLY REPORTING TOTAL GALLONS.
* Required for Ohio Clients
Use 2.642 for 10 liter Cubitainers Or
Zero for a Grab Sample

Have more than one sample?
Add the next sample site by clicking the "Add Another Sample" button below.

Add Another Sample Remove Remove Sample
Maximum upload size: 52.43MB

Please if a paper copy is desired please print out form before hitting submit button.  

Siganture:_______________________ Date: [todaysdate]

Ship Sample via Overnight Service to :
Environmental Associates Ltd.
24 Oak Brook Dr., Ithaca, NY 14850
Phone 607-272-8902