18 St Johns Avenue New Town 7008

Analytical Services Tasmania

Phone:(03) 61653300

Email:

Website:

Safety: Customer Duty of Care(must be filled in and signed)

Staff at the laboratory must be informed of the hazardous nature of any samples submitted. The following information must be completed before samples will be received and processed.

Please advise of all known HAZARDS:

No known hazardOther: detail below

Corrosive PCBFish ProductsPetroleum / HydrocarbonsContaminated Site: detail below

Sewage Toxic Animal ProductsTip LeachateCyanobacteria /Algal toxins

Please detail the nature of the hazards present in sample(s):______

______

Signed:______Date: ______

Customer Details

Customer Name:______

NOTE: The customer is the person or company who will incur charges for samples submitted to the laboratory for analysis.

Customer Address(New Customers Only):______

Person to direct invoice to: ______ABN:____-_____-_____-_____

(New Business Customers Only)

Submitted by:______Phone (submitter):______

Report to:

______Email: ______Phone:______

Other information: ______

JobDetails

Project Name:______

AST Quote No:______Customer Purchase Order No: ______

Turnaround time is 10 working days unless otherwise negotiated

Chain of Custody: from sampler to laboratory

Are these sample(s) subject to LEGAL proceedings?NoYes

Are these QUARANTINE sample(s)?NoYescomplete information below

Country of Origin: ______Import Permit Number:______

Quarantine Entry No:______Quarantine Movement*:______

(*Only required if AST is not listed on Import Permit)

Relinquished by: / Date / Time (24h) / Received by: / Date / Time (24h)

Please attach extra sheets if there is insufficient space to indicate the analyses required

Water Submission editablePage 1 of 1

Enter Sample ID below (mandatory for all submissions)
Enter analysis categories for each sample in boxes to the right.
# Enter specific details of tests required in lower section. / Sample type
eg
Algal
Fresh
Saline
Bore / Date
Sampled / Time Sampled
(24 hour) / Physical Properties / Bulk Properties / Nutrients Total / Nutrients Dissolved / Anions / Metals Total / Metals Dissolved / vTRH, TRH, TPH / Pesticides/ Herbicides / PAH / VOCs / PCBs / Bacterial Endotoxins / Bacteriological Testing / Cyanobacterial Toxins / Algal / Holdbefore analysis *** / Holdafter analysis *** / *** Samples placed on hold will be kept for three months only, unless subject to legal proceedings
Other analytes are available on request: please contact laboratory staff: 61653301
Other Parameters

Select analyte(s) by ticking the box or circling individual analyte(s)

Physical Properties
□pH
□Conductivity
□Acidity
□Alkalinity (Total)
□Alkalinity (CO3)
□Alkalinity (HCO3)
□Total Solids
□TSS TSS 0.45m
□Total Dissolved Solids
□Colour (Apparent)
□Colour (True)
□Turbidity
□Hardness*
* Note: Hardness also requires analysis of Ca & Mg
Bulk Properties
□BOD
□COD
□Chlorophyll a (Water)
□Chlorophyll a (Filter)
□NPOC
□NPOC Dissolved
□Oil and Grease / Nutrients -Total
□Nitrogen-Total*
□Nitrogen-Total Kjeldahl
□Phosphorus-Total
* Note: Total Nitrogen also requires analysis of Total Kjeldahl Nitrogen, and Nitrate + Nitrite
Nutrients -Dissolved
□Silica, Molybdate Reactive
□Ammonia
□Nitrate
□Nitrite
□Nitrate + Nitrite
□Phosphorus, Dissolved Reactive
Anions
□Br-, Cl-, F-, SO42-
□Sulphite, Thiosulphate
□Sulphide
□Cyanide: Total / Metals -Total
□Al, As, Ba,Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Mo, Na, Ni, Pb, Se, Zn.
□Hg
□Private Water Suppliers suite: As, Ba, Cd, Cr, Cu, Mn, Mo, Ni, Pb, Se plus Hg
Metals -Dissolved
□Al, As, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Mo, Na, Ni, Pb, Se, Zn.
□Hg
□Cr (VI)
vTRH & BTEX/N
□vTRH: C6-C10
□BTEX: Benzene, Toluene, Ethylbenzene, o,m & p-Xylene
□Naphthalene
TRH/TPH
□TRH: >C10-C16, >C16-C34, >C34-C40 Fractions
□TRH: with Silica Clean-up
□TPH: C6-C9, C10-C14, C15-C28, C29-C36
□TPH: with Silica Clean-up (C10-36 only) / □OC/OP Pesticides: a-BHC, b-BHC, d-BHC, g-BHC, Aldrin, Chlordane, Chlorpyrifos, p,p'-DDT, p,p'-DDD, p,p'-DDE, Diazinon, Dieldrin, Dimethoate, Disulfoton, Endosulfan I, Endosulfan II, Endosulfan sulphate, Endrin, Endrin aldehyde, Ethyl parathion, Famphur, Heptachlor, Heptachlor epoxide, Hexachlorobenzene, Malathion, Methyl parathion, Phorate, Sulfotep, Thionazin
□Other Pesticides/Herbicides (select as required): 2,4-D, Alphacypermethrin, Atrazine, Boscalid, Clopyralid, Dicamba, Fenitrothion, Haloxyfop-methyl, Hexazinone, MCPA, Metalaxyl, Metsulfuron-methyl, Pendimethalin, Permethrin, Picloram, Prometryn, Simazine, Sulfometuron-methyl, Terbacil, Triclopyr
□Glyphosate
□PAH: (USEPA priority suite): Acenaphthylene, Acenaphthene, Anthracene, Benzo[a]anthracene, Benzo[a]pyrene, Benzo[b&k]fluoranthene, Benzo[ghi]perylene, Chrysene, Dibenzo[a,h]anthracene, Fluoranthrene, Fluorene, Indeno[1,2,3-cd]pyrene, Naphthalene, Phenanthrene, Pyrene
VOC's
□Trihalomethanes
□VOCs: full suite – 59 analytes
□Haloacetic Acids
□Formaldehyde, Acetone / □PCB’s
□Bacterial Endotoxins
Bacteriological Testing*
□Thermotolerant coliforms, E. coli (by Membrane Filtration)
□Coliforms, E. coli (by Colilert)
□Enterococci
□Heterotrophic Plate Count @ 35°C
* Bacterial analysis is outsourced to the Department Of Health Public Health Lab
Cyanobacterial Toxins
□Microcystins: as Microcystin-LR
Algae Fresh Water
□Identification Only
□Identification & Cyanobacteria Only Count
□Identification + Full Count
Algae Marine Water
□Identification Only
□Identification + Count
□Identification & Relative Abundance

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