SAMPLE SUBMISSION FORM
Client:______________________________________________________________________
Address:____________________________________________________________________
___________________________________________________________________________
Phone:______________________________________________________________________
Email:______________________________________________________________________
Contact:____________________________________________________________________
Date Shipped:________________________________________________________________
(Email [email protected] prior to shipping. Samples accepted Monday - Thursday.)
SAMPLE INFORMATION:
Product Designation:_________________________________________________________
Product Lot:________________________________________________________________
Quantity:__________________________________________________________________
Storage Conditions:__________________________________________________________
Testing Required:____________________________________________________________
__________________________________________________________________________
Include Product Data Card / COA (needed for Protocol) ____YES________NO__________
Results Needed by:__________________________________________________________
PO #_____________________________________________________________________
COMMENTS:_______________________________________________________________
___________________________________________________________________________
Ship to:
Presque Isle Testing Laboratories
2221 Peninsula Drive
Door C
Erie, PA 16506
