WATERCARE SERVICES LTD, LABORATORY SERVICES, STANDARD FORMS, SAMPLE RECEPTION

Sample Reception Ph (09) 539 7614 or 539 7615 Fax (09) 539 7620 E-mail clientsupport@water.co.nz

CLIENT DETAILS

No. Sample Description Sample Date TimeType Sampled Sampled

1

2

3

4

5

6

7

8

9

10

Information in red is the minimum required for existing clients. For new clients asterisked(*) sections must also be completed.

SO Soil SH Shellfish SW Seawater/Saline content TW Tradewaste

Results To*:

SAMPLE TYPES PW Potable water LAS Potable water for LAS compliance FW Fresh water WW Wastewater SL Sludge

Received at Watercare Lab Services Condition on Receipt

Temperature:

Watercare Services Limited, Laboratory Services, 52 Aintree Ave, Airport Oaks, PO Box 107028 Auckland Airport, Manukau 2150

Order No:Client Code (Office use only) :

BATCH NO:

Tests Required (list here or use check boxes on reverse side)

Contact*:

Job Profile (office use only) :

Ph*:

Additional Information:

Date: Time:Date:

CHAIN OF CUSTODY RECORD Please tick this box if you require the COC to be emailed back to you

Client Request Form / Chain of Custody

Signature:

Name: Name:

Signature:

Charge To (if other than client):

Frozen

Address*:

Sent to Watercare Lab Services

Room TemperatureChilled

SFSR01 Version 8, 05 March 2009 Page 1 of 2

Name:

Fax: Quote No:

Email*:

Time:

If you require assistance with selecting tests please ask oneof our Sample Receptionists for help. However, please notethat if your testing is for regulatory or compliancerequirements such as food production or resource consents,we can not advise you what you will require, you will need tocontact the appropriate regulatory body. If you need yourtesting requirements to meet a particular standard pleaserecord this clearly on the sheet and inform the SampleReceptionist when you deliver the samples. With regard todrinking water, we are commonly asked to analyse watersamples and confirm that the water is 'safe' to drink. Due tothe number of possible contaminants that may be present inwater it is not possible for us to do this. However, what wecan do is analyse particular determinands and advisewhether or not they meet the NZ Drinking Water Standards2008.

As a purely analytical laboratory we do not provide writtenreports with an interpretation of your test results. If you wishus to make any comment on the laboratory report, pleasediscuss this with us at the time of delivery, to see if we canaccommodate your requirements. For further information ondrinking water, please refer to the following websites:

Tests

Reporting

Please note that our standard turnaround time for most testsis 10 working days. For a faster turnaround time please talkto one of our Sample Receptionists.

Turnaround Time

www.moh.govt.nz - NZ Drinking Water Standards 2008

www.drinkinwater.co.nz - general information

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ANALYSIS OF YOUR WATER

WATERCARE SERVICES LTD, LABORATORY SERVICES, STANDARD FORMS, SAMPLE RECEPTION

SFSR01 Version 8, 05 March 2009

AlkalinityAmmoniaBODBromateBromideChlorateChlorideChloriteCODColourConductivityCyanideDODOCFluorideIodideIon BalanceNitrateNitriteOil & GreasepH

Phosphorus TotalSulphateSulphide

TKNTOCTotal NTotal SolidsTurbidityUVVolatile MatterOther

GENERAL TESTS

Phosphorus Soluble

Total Dissolved SolidsSuspended Solids

Bore ChemistryBore Microbiology

BORE WATER PROFILES

Total SolubleAluminiumAntimonyArsenicBerylliumBoronCadmiumCalciumCobaltChromiumChromium 6CopperHardnessIronLeadLithiumMagnesiumManganeseMolybdenumMercuryNickelPotassiumSeleniumSilverSodiumZincOther

METALS

Tick this box if you require ultra-trace level metals for NZDWS2005 or other compliance

NB: For solid samples, analysis is forrecoverable (not total) metals

OCP

BTEXTPHPCBFormaldehydeVolatile FattyTaste & OdourOther

E.coli

EnterococciEnterolertEnterovirus

Giardia & CryptosporidiumHPC 22ºC 35ºC 37ºCPhagePseudomonasTotal ColiformsSalmonellaOther

PHN

SVOC

PAH

HAA

GC/GCMS

Acid HerbicidesDHA

Colilert 18 hr presumptiveColilert 18 hr enumeration

Faecal ColiformsFaecal Coliforms (MPN )Faecal streptococci

VOCVOC by Thermal DesorptionTHM

Tick this box if the sterilebottles provided containsodium thiosulphate

MICROBIOLOGICAL TESTS