Oil Spill Response Sample Chain of Custody Document
1. Sample Information
Project Name/Number
Date/Time Collected
Location
Sample ID
Sample Type
Preservation
Collected By
Matrix
2. Analyses Requested
Analysis
3. Chain of Custody Record
Date/Time
Released By (Name/Signature)
Received By (Name/Signature)
Purpose of Transfer
4. Additional Remarks
Sampler Signature
Date:
Lab Receiver Signature
Date:
Others
Date: