Feed Sample Submission Form

FEED SAMPLE SUBMISSION FORM V3

Form for the Submission of Feed Samples

Client name (company):*
Telephone number:*
Fax number:
Client contact person:*
E-mail address:*
Client No. (Account No.)*
Sampling date*
Date Format: MM slash DD slash YYYY
Vat No.

For Laboratory Use Only:
Samples received by:
Delivery date and time:
	Courier	Post	Delivered
Samples send via:

Condition upon arrival: (acceptable/or specify)

Submission of the FEED SAMPLE SUBMISSION FORM constitutes acceptance of the terms, conditions and fees for the analyses requested with the fees becoming due upon the receipt of the samples by CAL as requested in this form.
ANALYSES REQUESTED

*** WHEN SELECTING A PACKAGE PLEASE INDICATE SPECIES REQUIRED ***
Tests
No samples will be accepted without being accompanied by a FEED SAMPLE SUBMISSION FORM

***All proximate analyses in packages will be predicted by NIR.***
***Alle naaste analises in die pakkette word deur die NIR beraam.***
### For the list of available products please contact CAL. ###
### Skakel CAL vir die lys van beskikbare produkte. ###
Finished Feed Basic***
- Test Required
(NIR Protein, NIR Moisture, Ca and P)
Finished Feed Basic Sample 1 Order Number
Finished Feed Basic - Sample 1 Description
Finished Feed Basic Sample 2 Order Number
Finished Feed Basic - Sample 2 Description
Finished Feed Basic Sample 3 Order Number
Finished Feed Basic - Sample 3 Description
Finished Feed Basic Sample 4 Order Number
Finished Feed Basic - Sample 4 Description
Finished Feed Complete***
- Test Required
NIR Complete (all analytes within the database) + Total Mineral Package (Ca, P, Na, Cu K, S, Mg, Fe, Mn and Zn)
Finished Feed Complete Sample 1 Order Number
Finished Feed Complete - Sample 1 Description
Finished Feed Complete Sample 2 Order Number
Finished Feed Complete - Sample 2 Description
Finished Feed Complete Sample 3 Order Number
Finished Feed Complete - Sample 3 Description
Finished Feed Complete Sample 4 Order Number
Finished Feed Complete - Sample 4 Description
Comments
Please print this out, sign it in the box below and fax it to +27 11 474 0846 or email it to feeds@calsa.co.za.

Submitter signature:

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Feed Sample Submission Form

FEED SAMPLE SUBMISSION FORM V3

For Laboratory Use Only:

Samples received by:

Delivery date and time:

Courier

Post

Delivered

Samples send via:

Condition upon arrival: (acceptable/or specify)

ANALYSES REQUESTED

Tests

Please print this out, sign it in the box below and fax it to +27 11 474 0846 or email it to feeds@calsa.co.za.

Submitter signature: