Bottle Orders

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Bottle Orders

Sample Bottle Request Form

Please provide your e-mail address to receive confirmation. If you have not received confirmation within 24 hours, call us at 906-822-7889, or you can place an order directly by calling the number above.

Go to Method, Sample Container, Preservative, Holding Time Table

FIELDS IN RED = REQUIRED
(if not completed, submission will be rejected)

Company Name:

Contact Name:

Shipping Address 1:
Shipping Address 2:

City ,State ZIP Code

Phone Number:

E-mail:

Shipping Method:

Date Required:

Federal Express Account Number (if required):

# of Bottles	Description	Preservative	Comments
	40 mL VOC Vial	with HCl
	40 mL VOC Vial for Trip Blank	with HCl	Filled with Purged Water
	4-6 oz Glass Wide-Mouth Jar
	1 L Amber Wide Mouth Glass
	125 mL White Plastic (HDPE)
	250 mL White Plastic (HDPE)
	500 mL White Plastic (HPDE)
	1 L White Plastic (HDPE)
	500 mL White Plastic (HPDE)	with HNO₃	Preservative Added
	1 L White Plastic (HDPE)	with HNO₃	Preservative Added
	500 mL White Plastic (HPDE)	with H₂SO₄	Preservative Added
	1 L White Plastic (HDPE)	with H₂SO₄	Preservative Added
	125 mL White Plastic (HDPE)	Water Filled	Temperature Blank
	Medium Cooler (20-30 Quart)
	Large Cooler (48 Quart)
	Bubble Wrap (1 linear foot units)
	Nitric Acid Ampule (1:1)
	Sulfuric Acid Ampule (1:1)
	Sodium Hydroxide Ampule (10N)
	VOC in Soils Kit	Methanol	Tared VOC vial, 10 cc syringe, 10 ml methanol, flip-top plastic for solids
	Bottle Labels
	Chain of Custody

Project Name:

Comments: If you prefer, type in parameters and number and type (soil, water) of samples and we can send the appropriate bottles to you. (Replace this comment with your own.)