KLS Sample Submission Form

                
Ship samples to:
Kroff Lab Services, Inc
2301 Duss Ave
Building 1A, Suite 34
Ambridge, PA 15003
                
Lab Phone: 412-224-6000
Lab Email: KLS_Total@kroff.com
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Old Online Submission Form

KLS Sample Submission Form

Name*:                Form ID:
Submission Date: Today's Date                  Sample Date:
Email*:
Phone Number:
Account Name*:            Existing Customer           Prospect
Estimated Annual Account Revenue:
Account City & State:
Kroff Company:
Number of Samples:            Requested Turnaround Time or Date:
Shipment Carrier:
Tracking Number (if known):
Analysis Billing:       Deduct           Bill to Customer
Reason for Sample Submission:
*Required for submission

Sample Name System Type Treated? (Y/N) Treatment Description Standard Water Analysis ¹ Deposit Analysis Microbio Testing Product Analysis Treatment Testing Additional Testing ² and/or Comments and/or Hazards ³
¹ Standard Water Analysis of Makeup, Boiler, Process, Drinking, RO, and Misc/Unidentified Systems Includes: pH, cond, alkalinity, chloride, sulfate, total phosphate, silica, aluminum, barium, boron, calcium hardness, magnesium hardness, total hardness, copper, iron, manganese, molybdenum, potassium, sodium, strontium, zinc
¹ Standard Water Analysis of Closed Loop System Includes: TTA, nitrate, nitrite, pH, cond, alkalinity, chloride, sulfate, total phosphate, silica, aluminum, barium, boron, calcium hardness, magnesium hardness, total hardness, copper, iron, manganese, molybdenum, potassium, sodium, strontium, zinc,
¹ Standard Water Analysis of Cooling Tower System Includes: TTA, phosphonate, pH, cond, alkalinity, chloride, sulfate, total phosphate, silica, aluminum, barium, boron, calcium hardness, magnesium hardness, total hardness, copper, iron, manganese, molybdenum, potassium, sodium, strontium, zinc
¹ Standard Water Analysis of Wastewater System Includes: TSS, turbidity, COD, sulfur, phosphorus, silicon, arsenic, cadmium, chromium, lead, nickel, selenium, pH, cond, aluminum, barium, boron, calcium hardness, magnesium hardness, total hardness, copper, iron, manganese, molybdenum, potassium, sodium, strontium, zinc
¹ Standard Water Analysis of Leachate System Includes: TIC, COD, ATP, pH, cond, alkalinity, chloride, sulfate, total phosphate, silica, aluminum, barium, boron, calcium hardness, magnesium hardness, total hardness, copper, iron, manganese, molybdenum, potassium, sodium, strontium, zinc
¹ Standard Water Analysis of Disposal Well System Includes: TSS, ATP, viscosity, specific gravity, phosphonate, pH, cond, alkalinity, chloride, sulfate, total phosphate, silica, aluminum, barium, boron, calcium hardness, magnesium hardness, total hardness, copper, iron, manganese, molybdenum, potassium, sodium, strontium, zinc
² List any individual parameters to be tested alone OR parameters to be tested in addition to standard water analysis
³ Please note any of the following hazards and contact KLS prior to shipping:
Additional Comments about Project:

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