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Lift Tape Sampling Instructions
Professional Certification Institute
LIFT TAPE SAMPLING CHAIN OF CUSTODY
Form
This lift tape sampling chain of
custody is a mold laboratory form that is completed by the tester (property
owner, manager,
or agent or employee thereof), who collects the lift tape samples and
records the details of each sampling on this form. This form also serves
to document both the transfer of custody of the lift tape samplings
directly from the tester to the mold lab,
and their receipt by the lab. Please mail
(airmail or postal global priority mail) the lift tape samples and this
completed
Chain of Custody form to the Professional Certification Institute.
Tester’s name
________________________________________________________________________________________
Client name
___________________________________________________________________________________________
Client mailing
address:_________________________________________________________________________________
_____________________________________________________________________________________________________
Client Daytime Phone: (________) ___________________________ Client FAX
(________)________________________
Client Email:______________________________________________________ Date of
sampling____________________
Sampling
address______________________________________________________________________________________
______________________________________________________________________________________________________
Type of laboratory mold analysis to be performed:
____ mold verification & quantification (US$149 for each group of 10 lift
tape samples).
____ mold verification, quantification, & mold species identification
(US$224 for each group of 10 lift tape samples).
|
Sample Number
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Specific Lift Tape
Sampling Location |
Room
Width |
Room
Length |
Notes |
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[Home] [Up] [List of Mold Inspector Links] [Do-it-yourself Mold Products and Services] [Lift Tape Instrucions] [Chain of Custody Form] [Mold Test Interpretation] [Mold Testing Laboratory] [Physical Mold Samples] [Test Instructions] [Mold-In-Water-Testing] |