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...Ministry of moe lims drinking water sample submission the environment and chain custody for confirmation a screening analysis safe act please print or type clearly in blue black ink only shaded areas laboratory use information id is this new are these samples from system under yes no page o reg add to not regulated priority pr client program code date submitted time original attached study project yyyy mm dd hr min legal name number owner operator telephone local medical officer health tel location source surface ground contact last first awqi address unit street city town province postal incl area fax by signature x received potential hazardous be completed if there suspected hazard associated with potentially whmis safety data field s flammability member contacted reactivity precautions protection comments request matrix wd containers sent missing elisa result reported sac free cl total description raw treated distribution utm zone easting northing collection method map datum accurac...