CHAIN OF CUSTODY Aemtek No:___________________
  4630 Warm Springs Blvd., Suite A Phone: 510-979-01979
  Fremont, CA 94539 Fax: 510-668-1980
Contact Information Project Information
Company:  Contact:   Project ID/Phase:
Address:    Site:
Phone:  Fax:  E-mail: 
Report preference (circle one) 1. Fax 2. e-mail 3. both fax and e-mail
Sampled By:
Date: / /
Sample ID Sampling Location Volume(L) or
Area (sq. in.)
Analysis Required Sample Type Turn Around
Please Use Codes on the right or Specify
Relinquished by Date & Time Recieved by Date & Time Notes:
Call 510-979-1979 with your specific analytical needs and concerns. To ensure quality service, we reserve the right to reject inappropriately prepared/shipped samples. All analytical services subject to our terms and conditions. Digital photomicrography order must be placed before report being issued. Culture media and swab samplers are available and free of charge if returned to the lab for analysis. We customize report format upon request. If no turn around time indicated, standard report time applies. Samples received after 6:00 pm on business days or in the weekedn will be logged in the next business day. For "same day" service, samples must be received before 10 am; for "6 hours", 12 pm; for "3 hours", 3:00 pm. Our business hours are 9:00 am - 6:00 pm, PST, Monday - Friday.
Sample Type Codes
A - Air B - Bulk
C - Culture D - Dust
S - Swab s - Tape
W - Water Other:
Analysis Codes
FDE - Fungi Direct Exam: identifying fungi to genus or spore type. Rush services available
FCG - Fungi Culturable, identified to Genus only.
FCS - Fungi Culturable, common Species identification without subculturing
FCA/A - Aspergillus species ID, others to Genus
FCS/P - Penicillium species ID, ohters to genus
FCAS - Fungi Culturable, All Species identification excluding yeast, with subculturing if necessary. May need 10-21 days
DNA-ID - Microbial species identification-DNA sequancing.
EBC - Environmental Bacteria Count and Gram Stain
LED - Legionella Detection and quantification
SSC - Sewage Screen for total Coliforms, E. Coli , and enterococci. P/A
Allergen Screen - Testing for five common indoor allergens: dog, cat, cockroach, and dust mites ( Der f 1 and Der p 1)).
Turn Around Time Codes
STD: standard/default, 2 days for direct, 6-14 days for culturable, 2-3 days for bacteria detection.
5D - 5 days 3D - 3 days
1D - 1 dayr SD - Same day
6H - 6 hours 3H - 3 hours
WH - Weekend or holiday services. Prior notice required.