DOC: CB/CL/QR/5.8/AL-1
Issue No.: 03
Revision No.: 01
Issue Date: 21.01.2014
Sample Reg. No.: __________________________
CENTRAL POLLUTION CONTROL BOARD
Parivesh Bhawan, East Arjun Nagar, Delhi – 110 032
AIR LABORATORY
Field sheet cum receipt of Ambient Samples
1.
Sampling location
:
2.
Sampling team
:
1.
2.
3.
3.
Date of sampling
:
4.
Climatic condition
: Calm/windy/clear/cloudy/semi cloudy/rains/fog/snowfall
(Please tick mark the correct option)
5.
Ambient temperature
:
6.
Field observations
:
A.
For Suspended Particulate Matter (SPM) / Respirable Suspended Particulate Matter (RSPM)
S.
No.
Filter Paper
Number
Parameter
(SPM/PM10)
Duration
From
Indentor
Incharge
(Indenting Division
To
Total
sampling
time (min.)
Average
flow rate
(m3/min.)
Incharge
(Air Lab) Section)
Remarks
Incharge
(Sample Receiving)
Sample Reg. No. __________________
ACKNOWLEDGEMENT
Received ___________ samples from No. _______ to _______ on _______________ at _________ a.m./p.m. from
___________________ Division for Physico-Chemical / Biological / _______________________________ testing.
Date :
Signature
DOC: CB/CL/QR/5.8/AL-1
Issue No.: 03
Revision No.: 01
Issue Date: 21.01.2014
Sample Reg. No.: __________________________
CENTRAL POLLUTION CONTROL BOARD
Parivesh Bhawan, East Arjun Nagar, Delhi – 110 032
AIR LABORATORY
Field sheet cum receipt of Ambient Samples
B. For gaseous Pollutants
S.
No.
Sample
Code
Note: 1.
Parameter
Monitored
Duration
From
To
Total
sampling
time (min.)
Average
flow rate
(LPM)
Total vol.
of sample
(ml)
Remarks
Indicate following conditions, if any, during sampling
 Sample contamination
 Damaged filter paper
 Sample lost
 Sample preservation
 Any other
Indentor
Incharge
(Indenting Division
Incharge
(Air Lab) Section)
Incharge
(Sample Receiving)
Sample Reg. No. __________________
ACKNOWLEDGEMENT
Received ___________ samples from No. _______ to _______ on _______________ at _________ a.m./p.m. from
___________________ Division for Physico-Chemical / Biological / _______________________________ testing.
Date :
Signature