quality standards - Labicom

Custom Solutionsand Mixture FormRequest FormACCOUNT NUMBER ______________________________________________________ DATE ___________________________________CUSTOMER NAME ______________________________________ COMPANY NAME _________________________________________ADDRESS ___________________________________________________________________________________________________________CITY/STATE/ZIP _____________________________________________________________________________________________________PHONE______________________________ FAX ___________________________ EMAIL ______________________________________If reordering a custom standard please provide Part# or Quote# ________________________________________________EPA METHODChem SerPWest Chester, PA 19381-0599rvice.comANALYTE CATALOG # CAS# CONCENTRATION1. ________________________________________________________________________________________________________________2. ________________________________________________________________________________________________________________3. ________________________________________________________________________________________________________________4. ________________________________________________________________________________________________________________5. ________________________________________________________________________________________________________________6. ________________________________________________________________________________________________________________7. ________________________________________________________________________________________________________________8. ________________________________________________________________________________________________________________9. ________________________________________________________________________________________________________________10. ________________________________________________________________________________________________________________11. ________________________________________________________________________________________________________________12. ________________________________________________________________________________________________________________13. ________________________________________________________________________________________________________________14. ________________________________________________________________________________________________________________15. ________________________________________________________________________________________________________________16. ________________________________________________________________________________________________________________17. ________________________________________________________________________________________________________________18. ________________________________________________________________________________________________________________19. ________________________________________________________________________________________________________________20. ________________________________________________________________________________________________________________21. ________________________________________________________________________________________________________________22. ________________________________________________________________________________________________________________TOTAL # OF ANALYTES: __________DESIRED CONCENTRATION AND SOLVENT: _______________________________________________________________________VOLUME (check one): 1mL______ 2mL______ 5mL______ 10mL_______ Other_________ # of Units: ______________________MSDS provided with all standards.Amber Ampules used unless specified otherwise:_____________________________DOCUMENTATION (check one): Gravimetric Certification: Guarantees the analytes in the custom standard to be made within ± 5% of specifications. Quantitative Certification: Includes verification of the concentration and peak identification.All mixtures are prepared in accordance with our ISO 9001 & ISO 17025 registration. All analytes are certified >/= 98% unless noted. Corrections are made to 100% purity.8 Chem Service’s Quality Management System is Certified to the Internationally Recognized ISO 9001 & ISO 17025 Quality Standards.