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Sample Submittal Form

Sample(s) submitted by (company, person): Project name: TESTING INFORMATION Sample Name/Description(s) (e.g. rootzone mix, etc.): Sample Location/ Date Sampled: Tests to be run (please circle): Sand Cap Evaluation

Particle Size Analysis

Gravel Gradation Soil Texture

Infiltration Rate

USGA Performance Evaluation Other test(s) (please specify):

Bunker Sand Evaluation

Water Release Characterization Nutrients

Organic Matter

SPECIFICATIONS * Rootzone Specifications (please circle one): USGA Greens Fairways/Tees Bunker Sand Infield Skin Green Roof California Greens Retention Basin Sports Fields Other** Synthetic Turf

Rootzone Depth (in.):

Gravel Blanket Depth (in.):

Other Specifications or Testing Instructions: BILLING INFORMATION Billing Party: Billing Address:

P.O. Number (if applicable): Primary Phone Number: Fax Number: Other parties to receive results: Signature of Billing Party: Title:

Secondary Phone Number: Email Address:

Date: Please send this completed form in with each sample submittal to:

Turf Diagnostics and Design

613 E. 1st St. Linwood, KS 66052 USA Phone: 1-913-723-3700 Email: [email protected] Web: www.turfdiag.com

* The specifications section of this form only needs to be completed with the first sample submittal for each project. ** At the start of each project, please include a copy of the materials/testing specifications, so that proper testing can be performed.

March 2010

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Microsoft Word - Sample Submittal Form 2010.doc

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