Stormwater Discharge Sampling Chain of Custody Log
Project Name:
Location:
Date:
Sample ID:
Sample Type:
Sampled By:
Field Measurements
Parameter
Value
Units
Temperature
pH
Turbidity
Other
Laboratory Analyses Requested
Analyte
Preservative
Sample Container
Lab ID
Chain of Custody Record
Date/Time
Released By (Print & Sign)
Received By (Print & Sign)
Purpose/Location
Remarks / Comments