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Test Specimen Shipping Form

 

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Test Request Form

Customer Information

    
Date of Request: Contact:
Company Name: E-mail Address:
Address: Phone:
City, State, and Zip Fax:

Sample Information

  
Department To Perform Testing: Date Due:
PO/Job Number (if one already opened): Service:
ATS Contact (if known):    

Requested Tests:

Test To Be Performed (validation of customer provided, non-standard test methods must be specifically requested):
(Maximum characters: 1000)
You have characters left.
Quantity Description of Item*
Quantity Description of Item*
Quantity Description of Item*
Quantity Description of Item*
      *MSDS must accompany any liquid, powder, or potentially hazardous material submitted

Report Format

      
How would you like to receive report: Email or Fax:    

Sample(s) Disposition After Test
Return Shipment Method-Not a guaranteed Service. Dependent upon carrier. Payment Method-Not a guaranteed Service. Dependent upon carrier.
Shipment Method:
Account No.
Specify Carrier
   
   
*An Applied Technical Service, Inc (ATS) representative will contact requestor for further information
 

Sign and Date

    
Sign: Date:

We appreciate the opportunity to provide your testing,calibration or inspection needs and look forward to being of service to you. Services provided will be governed by the Applied Technical Services, Inc (ATS) General Conditions of Service available at: www.atslab.com/salesorderacknowledgement.pdf Services Performed outside scope of Applied Technical Services, Inc (ATS) accreditation are certified to ISO 9001 requirements only.

ATS 057 03/10
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Please Include Form With Shipment

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