Company Name: Division: Contact: Phone: PO#: Date Needed: ITEM QTY ORDER CODE Matrix Sponge, High Density Polyurethane, 10mL, No Glove, w/Stick 100/case SUPMTRXSWAB 20/pack (Keep cool, do not freeze) SampleRight, High Density Polyurethane Sponge, w/Gloves, No Stick 100/case SUPSR10HCHDPURG 20/pack (Keep cool, do not freeze) EZ Reach, Polyurethane, 10mL, w/2 Gloves 100/case SUPEZ10HCPURG 20/pack (Keep cool, do not freeze) EZ Reach, Split-Sampler, 20mL 60/case SUPEZSP20HCPUR (Dual Sponges) (Keep cool, do not freeze) Veriswab, 4mL 100/case SUPVS4LET (for residual testing) (Keep cool, do not freeze) Veriswab, 10mL 100/case SUPVS10LET (Keep cool, do not freeze) BD Culture Swabs 50/pack SUPL4320116 (Keep cool, do not freeze) Water Collection Bottles Each SUP0973091 (Potability) Water Collection Bottles Each SUP0973091A (Chemistry) Water Collection Bottles Colilert Each SUPWV120SBST Air Plates Aerobic Count 10/Sleeve SUPPLATESPC (Keep cool, do not freeze) – Air Plates Yeast & Mold Count 10/Sleeve SUPPLATESPDA (Keep cool, do not freeze) – ATP Swabs Lot#: 100/box SUPUS2020 (Keep cool, do not freeze) Exp. Date: Allergen Environmental Swab Kit Each SUP8432S 24oz Whirl-pak Bags Each SUP14955180 Additional Item:
Company Name: Division: Contact: Phone: PO#: Date Needed: ITEM QTY ORDER CODE Matrix Sponge, High Density Polyurethane, 10mL, No Glove, w/Stick (Keep cool, do not freeze) 100/case 20/pack SUPMTRXSWAB SampleRight, High Density Polyurethane Sponge, w/Gloves, No Stick (Keep cool, do not freeze) 100/case 20/pack SUPSR10HCHDPURG EZ Reach, Polyurethane, 10mL, w/2 Gloves (Keep cool, do not freeze) 100/case 20/pack SUPEZ10HCPURG EZ Reach, Split-Sampler, 20mL (Dual Sponges) (Keep cool, do not freeze) 60/case SUPEZSP20HCPUR Veriswab, 4mL (for residual testing) (Keep cool, do not freeze) 100/case SUPVS4LET Veriswab, 10mL (Keep cool, do not freeze) 100/case SUPVS10LET BD Culture Swabs (Keep cool, do not freeze) 50/pack SUPL4320116 Water Collection Bottles (Potability) Each SUP0973091 Water Collection Bottles (Chemistry) Each SUP0973091A Water Collection Bottles Colilert Each SUPWV120SBST Air Plates – Aerobic Count (Keep cool, do not freeze) 10/Sleeve SUPPLATESPC Air Plates – Yeast & Mold Count (Keep cool, do not freeze) 10/Sleeve SUPPLATESPDA ATP Swabs (Keep cool, do not freeze) Lot#: 100/box SUPUS2020 Exp. Date: Allergen Environmental Swab Kit Each SUP8432S 24oz Whirl-pak Bags Each SUP14955180 Additional Item:
Client-Supply-Order-Form.docx