Analysis Request Form

Date: 27.09.2022 From: INCOLAN

Cargo type : Solid fuel Our Ref.: TNK/1296/22
Attention: Mr. LAB MANAGER To Lab.: TANKOIL LAB

Sample label: 1296- 6 SAMPLES FROM CEMEX ON 27.09.2022

Type of samples: □ Vessel / lots □ Factory Lots □ Yard / Lots □ submitted

Preparation request: - After received and prepared the samples, we have to follow the below

Empire
Requested Crushed sample Remain after pulverizing &
Total sample To be analyzed
Samples Retention analysis (rest of sample)
Retention
Number
Weight
Storage type
G. Instructions Have to mentioned exact weight of sample in each label at time of storage / storage date /

Note: -
Composite sample to be prepared from lot samples (special instruction from operation)
Above mentioned table for each /separate lot sample (default)
Rest of sample after pulverizing and analysis have to be retained with ID (in plastic jar)
Sample results duration: Max days including preparation time
Retention period: □ 3 Months □ 6 Months
Requested items for sample to be analyzed

Sample type / weight Items Test method

ASTM

SAMPLE 1 Proximate
SAMPLE 2
SAMPLE 3
SAMPLE 4
Sample 5
Sample 6

Priority Urgent Confirmation by lab

Deadline ASAP
By: Operation department
Name: Ahmed Hassan Signature: