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    Request for Quote

    PD Sampler Questionnaire

    Please fill out the form below and give us as much information about yourself as possible.

    Fields marked with an asterisk (*) are required.

    We will only use your e-mail address and information supplied by you to contact you about services/products that you have indicated are of interest to you.



    Contact Information

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    Purpose

    Manual Sampling Audit

    Other   

    Pricing: Budget  Firm

    Material Characteristics

    % Solids

    pH:

    Ambient Temperature:

    Min

    Max

    Sampler Requirements

    Handle Length Required (in metres):

    Sample Container Required cc

    Model 5100 1000 cc or Model 5030 300 cc

    Standard Container Material ABS:

    Special Container Material Stainless Steel: