CUSTOMER ANALYSIS REQUEST FORM WATER MICROBIOLOGY Company: _______________ Branch / Location: _____________ Date Samples Despatched: __/__/__ Company Contact for Analysis Report: _________________ Sender’s Name: _______________ Lancaster Quote / Ref: _________ ___ oC MF / PC MF / PC Enterococci ___ oC Pseudomonas Batch No./Sample point TBC @ Other Tests E. Coli Sample Description TBC @ Coliforms Sample No. WATER MICROBIOLOGY TESTS Sample Type PO No: ___ For Lancaster Use Only LAB NO. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Comments or if the analysis is non-routine and / or you have discussed the analysis with us, please state with whom: Notes: 1. Please state the temperature TBC is required at and whether it is to be done by Membrane Filtration (MF) or Plate Count (PC). 2. Where not otherwise specified, analysis will be performed as per agreed methodology. For routine analysis, Lancaster Labs prepares a Client Sample Sheet or Customer File for each sample type / client which includes the agreed methodology. This is used to instruct the Analysts involved.