HOW to fill out chain of custody forms ?
Sample Submission & Chain of Custody Instructions
(For Asbestos, Lead, and Mold Analysis)
To ensure accurate laboratory processing and compliance with regulatory standards, please complete the Chain of Custody (COC) form in full and follow the collection and handling guidelines below.
Incomplete or improperly completed submissions may delay processing.
1. Client and Project Information
Please provide:
Client / Homeowner Name
Address or Project Location
Contact Phone and Email
Date and Time Samples Collected
Sampler’s Name / Initials
2. Sample Information
For each sample, list:
Sample ID / Label (must match the container label)
Sample Type (e.g., drywall, insulation, paint chip, dust wipe, tape lift, air cassette)
Location / Area of Collection (e.g., kitchen ceiling, window sill, basement wall)
Date and Time of Collection
Requested Analysis
Asbestos: PLM (Polarized Light Microscopy) or TEM (Transmission Electron Microscopy)
Lead: Paint Chip, Dust Wipe, or Soil Analysis by AAS/ICP
Mold: Direct Microscopic Examination or Culture
3. Safe Sample Collection Guidelines
(For Homeowners and Non-Professionals)
If you are collecting samples yourself, proceed with extreme caution. Improper collection may cause personal exposure or compromise sample integrity.
All individuals collecting samples should wear:
A fit-tested half-face respirator equipped with P100 filters,
Disposable nitrile gloves, and
Disposable coveralls to prevent contamination and exposure.
Asbestos Samples
Lightly mist the area with water to minimize fiber release.
Using hand tools only (no power tools), carefully remove 1–2 teaspoons of representative material.
Place material in a clean, sealable plastic bag, double-bag it, and label clearly with sample ID and location.
Avoid disturbing large areas of suspected asbestos-containing materials (ACMs).
Lead Samples
Wear gloves and respirator at all times to avoid ingestion or inhalation of dust.
For paint chips: collect all layers of paint down to the substrate, approximately 1–2 cm² of material.
For dust wipes: use approved collection wipes and follow specified surface area protocols.
Place samples in clean, sealed containers, and label each with the sample ID and location.
Mold Samples
Use clean tape lifts, swabs, or air cassettes intended for mold analysis.
Wear full protective gear (respirator with P100 filters, gloves, and coveralls).
Avoid sampling in areas with excessive dust or unrelated debris.
Do not collect visibly wet or dripping materials unless specifically required.
Store samples in a cool, dry container and submit promptly to the laboratory.
4. Chain of Custody Signatures
To maintain sample traceability:
Sampler Signature / Date / Time (at collection)
Courier or Drop-Off Signature / Date / Time (if applicable)
Laboratory Receiver Signature / Date / Time (upon receipt)
Each transfer must be signed and dated to preserve custody integrity.
5. Limitations and Responsibilities
Sample Collection Responsibility
The submitting party (homeowner or client) is fully responsible for sample collection, handling, labeling, and documentation. The laboratory does not provide sampling services and assumes no liability for the manner or adequacy of sampling procedures.Volume and Representativeness
The laboratory analyzes only the material received. It is the client’s responsibility to ensure that the quantity, quality, and representativeness of samples meet the requirements for the intended analysis.Regulatory Compliance
Clients are solely responsible for ensuring that sampling activities comply with all WorkSafeBC, Health Canada, and applicable occupational health and safety regulations. The laboratory does not verify or enforce compliance with regulatory standards.Chain of Custody and Sample Integrity
The laboratory’s responsibility begins only upon formal receipt of the samples in the laboratory. All samples must be accompanied by a completed Chain of Custody form.Analytical Scope and Reporting
Laboratory results apply only to the materials submitted and cannot be extrapolated to other unsampled locations or materials.
6. Final Checklist Before Submission
All sample containers are labeled with unique IDs.
The Chain of Custody form is complete and signed.
Samples are sealed and packaged securely.
Contact information and requested analyses are clearly indicated.
CLEARCO - LEAD TESTING CHAIN OF CUSTODY.pdf Download here
CLEARCO- ASTM-FUNGAL ANALYSIS CHAIN OF CUSTODY.pdf Download here
CLEARCO NIOSH 9002 CHAIN OF CUSTODY.pdf Download here
CLEARCO-AIR- NIOSH 7400 COC.pdf Download here
Need Assistance?
If you require clarification regarding sample submission or Chain of Custody completion, please contact our laboratory before collecting or submitting samples.
Laboratory personnel can provide procedural guidance but cannot assist with field collection or regulatory interpretation.