Sample Submittal Form Client Code:

INTERNAL USE ONLY

Workorder # Received Date

WORKORDER DETAILS SAMPLE AND ANALYSIS DETAILS

Company Name: Sample Type: Overlimit Requirements: Special Instructions:

R-Rock SD-Sediment Report > no overlimit assay
Submitted by:
P-Pulp PC-Percussion Report via overlimit
Contact Number: method (charges
S-Soil DC-Drill core will apply)
Courier/Waybill: A-Solution (contact the lab) Other
Other
Date Shipped:

Project ID:

PO Number: HAZARDOUS MATERIAL IDENTIFIED? (fees may apply)

It is critical to identify hazardous samples such that safety risks can be mitigated
Dispatch #:
None Fibrous Radioactive Massive Sulphides Other:
ALS Quote #:

Sample ID Sample Preparation Analytical TYPE ORE

(R,S, etc.) GRADE QTY
Start # Finish # (Prep Code) (Elements or Method Code)

TOTAL
Check here for RUSH – PREMIUM SERVICE, CONTACT LAB TO CONFIRM AVAILABILITY SAMPLES

Webtrieve™
REPORTING DETAILS
Data File
Invoice

# Name E-mail

SAMPLE RESIDUE ARCHIVE AND RETURN DETAILS

All shipments received
IMMEDIATELY AFTER FREE STORAGE PERIOD* are subject to inspection
Sample Return
Return Discard Return Discard Paid storage upon layout; all services
Pulps – The <250g Master Pulp retained by the lab. are rendered in
accordance with ALS
Bulks – The remainder of large Pulp samples. Minerals Terms &
Conditions (see the
Rejects – Any remaining coarse unpulverised rejects. current Schedule of
Screen – Any screen reject fractions. Services & Fees).

Return address: * Free storage periods are: 45 days for coarse

rejects and bulk pulps, 90 days for Master
Attention: pulps and 45 days for screen reject fractions.

Authorised by:
Position Name Signature

alsglobal.com/geochemistry RESET
FM-AD-135 Rev: 08.03 Issue date: 12/07/2022 Page 1 of 1