PT&M

SAMPLE DATA SHEET

Client: ___________________________   Contact: ___________________________

Address: __________________________   Phone:  ____________________________

        ___________________________   Fax:  ______________________________

Description of Sample: (Note % of each component) ________________________

__________________________________________________________________________

__________________________________________________________________________

Sampling Site: ___________________________________________________________
Please attach process flow diagram and/or description of process which
produced sample.

What are the specific goals of treatment? ________________________________

__________________________________________________________________________

Please document the following parameters:

Consistency of sample when collected: ____________________________________

Consistency of material prior to the dewatering equipment that will be
replaced (if applicable): ________________________________________________

Bone Dry Tons Per Day (BDT/D) to be dewatered: ___________________________

For Rotary Thickener Testing Only: Gallons Perminute Flow: _______________

Date and time(s) Sample was collected:  __________________________________

Sample is a:     Flow-proportional composite
                 Composite
                 Grab
				 
Date and time sample was shipped: ________________________________________

Carrier: ____________________  Carrier's Tracking Number: ________________