Document 6529745

SAMPLE SUBMISSION SHEET
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2266
Client :
Contact :
Tel N0:
ANALYSES REQUIRED
6. P & PC
5.Closed.
sys
4.Table 8
3.Table 5
PC
Yeasts &
Moulds
Staph.
aureus
*
Other Tests
Chemical Tests (See overleaf )
BSRIA BG29/2012
Faecal
Coliforms
Clostridium
perfringens
Enterococci
NRB
SRB 21 Day
SRB 5 Day
Pseudo.
Spp @ 30ºC
Soil
Pseudo.
aeruginosa
@ 37ºC
VAC
Legionella
spp.
TVC 2 Day
@ 37°C
TVC 3 Day @
22°C
TVC 2 Day @
30°C
Surface
Bacteriological Tests
2.Table 5
M
Sample Details/Descriptions
Air
Job Number:
TURNAROUND ..........WORKING DAYS
1.Table 4
#CHEM
E coli. &
Coliforms
Order Number :
Contact Plates
For Laboratory Use ONLY
Correct Bottles: YES / NO
TVC 1 Day @
37°C
Date samples taken :
SWAB
GB17336
This Form acts as a contract of analysis required so please
complete correctly and legibly.
Site Details :
Water
GB2063
QUALITY MANAGEMENT MANUAL SECTION A ISSUE 2, V5
APPENDIX 14 Issued by B.PATEL 29-7-2014
For S.L. use
only
SLIMS
SAMPLE
NUMBER
1.
SL
2.
SL
3.
SL
4.
SL
5.
SL
6.
SL
7.
SL
8.
SL
For Client
For Stansted Laboratories Ltd
Relinquished by……………………………………
Received by………………………………………
#Standard Turnaround time for Chemistry
Visual check…………………………………………
Visual check………………………………………
Analyses is 10 working days please specify above.
Date : ………………………Time…………………
Date :…………………………Time………………
The additional Surcharge for quicker Turnaround is;
Name (printed) ……………………………………
Name (printed) …………………………………
3 DAYS @50%, 5DAYS@ 25% & 7 DAYS @15% . (Not available for WAC TESTS)
Unit 9, Riverside Ind. Est., 27 Thames Road, Barking, IG11 0ND – Tel: 020 8594 5104 – Fax: -020 8591 8762 – Email: sales@stanstedlabs.co.uk
Samples received OK
except those marked
* See advisory notes
Guidance for BSRIA & Chlorination Analyses
If you require additional analyses or tests not listed in the table below, please note required tests in the column marked "Other" on the
Sample Submission Sheet overleaf, we are very happy to provide assistance if you are unsure of the tests you require.
Suite
N0.
Analyses
Suite
1
BSRIA 2012
Table 4
2
BSRIA 2012
Table 5 M
3
Minimum
Minimum
Sample Volume Sample Volume
(Chemistry)
1 X 1 Litre
(Microbiology)
1 X 250 ml
MICROBIOLOGICAL TESTS
(Please individually select micro tests to your
specific requirements )
Total Alkalinity, Chloride, Sulphate, Conductivity, TDS(gravimetric),
SS, Heavy Solids, pH, Total & Soluble Iron, Total Copper, Nitrite ,
Molybdate,
Additional Tests if required: Soluble Copper, Total Aluminium,
Total Zinc,
TVC @22°C, Pseudomonas species @ 30°C
SRB 5 OR 21 days
Additional Tests if required: NRB (Table 6)
Sulphate, Conductivity, SS, Heavy Solids,, pH, Total & Soluble Iron,
Total Copper, Nitrite , Molybdate,
1 X 1 Litre
1 X 250 ml
(System Monitoring)
Additional Tests if required :Soluble Copper, Total Aluminium,
Total Zinc, Glycol ,*DO
BSRIA 2012
Table 5 PC
(Practical
1 X 1 Litre
1 X 250 ml
Total Alkalinity, Chloride, Sulphate, Conductivity, TDS(gravimetric),
SS, Heavy Solids, pH, Total & Soluble Iron, Total Copper, Nitrite ,
Molybdate
Additional Tests if required: Soluble Copper, Total Aluminium,
Total Zinc, Glycol, *DO
1 X 500 ml
1 X 250 ml
Sulphate, Chloride, pH, Hardness
Completion)
4
CHEMICAL TESTS
(Please let the Laboratory staff know if you would like to
remove or add Chemical tests)
BSRIA 2012
Table 8
TVC @22°C, Pseudomonas species @ 30°C
SRB 5 OR 21 days
Additional Tests if required: NRB (Table 6)
TVC @22°C, Pseudomonas species @ 30°C
SRB 21 days
Additional Tests if required: NRB (Table 6)
TVC @22°C, Pseudomonas species @ 30°C
(Fill Water Quality)
5
General Closed
System Tests
1 X 1 Litre
1 X 250 ml
Colour, Clarity, EC, pH, TDS, Nitrite , Molybdate, SS, Heavy Solids,
Total Alkalinity, Chloride, Sulphate, Total & Soluble Iron,
6
Pre & Post
Chlorination
(P & PC)
1 X 250 ml
1 X 250 ml
Free & Total Chlorine, Turbidity
* Chemical tests carried out on site are not UKAS accredited
TVC @37°C ,TVC @22°C, Coliforms & Ecoli
Additional Tests if required:
Enterococci, Pseudomonas aeruginosa
QUALITY MANAGEMENT MANUAL SECTION A ISSUE 2, V5 APPENDIX 14 Issued by B.PATEL 29-7-2014
Additional Instructions to Stansted Laboratory Staff (for Clients use):
Abbreviations
Chemistry:
TVC @37°C ,TVC @22°C, SRB 5 days
Pseudomonas species @ 30°C
Additional Tests if required: NRB (Table 6)
Microbiology:
EC = Electrical Conductivity
TVC = Total Viable Count
SS = Suspended Solids
SRB = Sulphite Reducing Bacteria
Sett.S = Settleable Solids
NRB = Nitrite Reducing Bacteria
TDS = Total Dissolved Solids
(By EC or Gravimetric @ 180°C)
*DO = Dissolved Oxygen,(sample should be collected in a glass bottle and
fixed with a preservative on site )
Date:
Name:
Phone N0.
Unit 9, Riverside Ind. Est., 27 Thames Road, Barking, IG11 0ND – Tel: 020 8594 5104 – Fax: -020 8591 8762 – Email: sales@stanstedlabs.co.uk