Welcome! to FAIRWAY LABORATORIES

Bottles Request

Fill out the form below and we will get your bottles ready.

Your Name*

Company Name*

Address*

Phone*

Email Address*

Date and Time that bottles are due to me (mm/dd/yy hh:mi am)*

Please pick delivery method*

Please pick any additional supplies/services

Extra Labels

Extra Chain of Custody Forms

Coolers

Trip Blanks

Temperature Blanks

Custody Seals

Pack Bottles by Sets

Bottleware COC required

Project Specific Labels

Your Project Name or Location

Bottles Required

Example:

No. of Samples	12
Matrix	Groundwater
Analysis Parameters/Methods	8260 VOCs, Lead, Mercury

No. of Samples*

Matrix*

Analysis Parameters/Methods*

No. of Samples

Matrix

Analysis Parameters/Methods

No. of Samples

Matrix

Analysis Parameters/Methods

No. of Samples

Matrix

Analysis Parameters/Methods

No. of Samples

Matrix

Analysis Parameters/Methods

Additional notes/comments to the laboratory

What is 1 plus 2?