Chain of Custody Sheet* eco-INSTITUT Germany GmbH Testing Sampler laboratory (Name, Schanzenstr. 6-20, D-51063 Cologne Company, Tel. +49 (0)221 - 931245-0 Phone) Fax +49 (0)221 - 931245-33 Name of Customer/ / Invoice recipient at place (if different from of sampling manufacturer) (Address / Stamp) Product name Product type (e.q. parquet, floor covering) Model / Batch / series Article number Date manufactured batch Plant name and Number of location sample pieces Samples are current production Sampling date taken from storage Sampling time Storage location production Storage open before sampling storage conditions packaged other: before sampling Storage location: Packaging material: Special features (possible negative effects through emissions at of sampling (e.g. enzene, exhaust fumes), unclarities, questions etc.) Shipping details Shipping date Packed and Carrier / Air bill shipped by no. Validation
Chain of Custody Sheet* Testing laboratory eco-INSTITUT Germany GmbH Schanzenstr. 6-20, D-51063 Cologne Tel. +49 (0)221 - 931245-0 Fax +49 (0)221 - 931245-33 Sampler (Name, Company, Phone) Name of / at place of sampling (Address / Stamp) Customer/ Invoice recipient (if different from manufacturer) Product name Product type (e.q. parquet, floor covering) Model / / series Batch Article number Date manufactured batch Plant name and location Number of sample pieces Samples are taken from current production storage Sampling date Sampling time Storage location before sampling production storage other: Storage conditions before sampling open packaged Storage location: Packaging material: Special features (possible negative effects through emissions at of sampling (e.g. enzene, exhaust fumes), unclarities, questions etc.) Shipping details Shipping date Packed and shipped by Carrier / Air bill no. Validation
eco-INSTITUT-Label_chain-of-custody-20170420_fillin.docx