South East Water
                    3 Columbus Drive
                    Southwood Business Park
                    Farnborough                                            Sample Submission Form
                    GU14 0NZ                                               (Electronic copies can be emailed to samples@southeastwater.co.uk)
                    Tel 01634 276 276
                    YOUR COMPANY NAME                                                                                 SAMPLE COLLECTED FROM (optional - e.g. site name/event etc)
                    ADDRESS
                    YOUR CONTACT NAME/ NUMBER                                                                         ORDER/JOB NUMBER
                                                   GW- Ground Water               US- Untreated Sewage                TE-Trade Effluent              S- Saline                      LL- Land Leachate
                    SAMPLE MATRIX KEY              SW- Surface Water              TS- Treated Sewage                  PW- Process Water              RW- Recreational Water         PL- Prepared Leachate
                                                   DW- Drinking Water             HW – Healthcare Water
                                                                                                           E
                                                                                                           L
                                                                                         E         E       P                                                                                    LIMS NUMBER
                                   SAMPLE DESCRIPTION                                    T                 M
                                                                                         A         M       A                           ANALYSIS REQUIRED                                        (laboratory use
                                  (e.g. kitchen tap, hot water)                                    I       S
                                                                                         D         T       X                                                                                          only)
                                                                                                           I
                                                                                                           R
                                                                                                           T
                                                                                                           A
                                                                                                           M
                    NOTE: If all fields are not fully completed this may delay the start of your analysis or your results could be reported as deviating
                    If you require a courier for these samples please arrange at least 24 hours before taking the samples by phoning 01634 276 276 
          UNCONTROLLED WHEN PRINTED                                 Water Quality - Laboratory  SEW by Department\Water Quality\Laboratory\Form-3036, Rev. 9.03, Issued 08/01/2020, Page
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