FORM 7
EP 1110-1-28
EXAMPLE CHAIN OF CUSTODY FORM
31 AUG 01
FOR LEAD RISK ASSESSMENT SAMPLING
Page
of
Project Name
Project Number
Sample Preparation/Analysis Required (check the appropriate box)
Installation
Project Manager
Company Name
Company Address
Phone
Sample ID
Sample Date
T ime
Sample Matrix
Laboratory ID
(wipe, paint chip,
soil, other)
B-21
Previous Page
