GKA Analytical Services | Exhibit Transmittal Form

EXHIBIT TRANSMITTAL FORM

Client Information

All correspondence regarding your exhibit, including Analysis Certificates and Analysis Reports, will be sent to the submitter listed below. Documents will be emailed to the address listed below. Please advise us if you would prefer the results to be sent via traditional mail.

Reference number:

Submitted by:

Company Name:

Phone number:

Email:

Mailing address:

Postcode:

Billing Information

Please provide billing information for invoicing purposes.

Issue invoice to:

Company name:

Mailing address:

Postcode:

Phone number:

Email:

Examinations Requested

We are able to perform various examinations on your exhibit, depending on the type of material being submitted. If you are unsure of the type of examination you require, please contact our office. Some examinations may only be possible on certain exhibit types; please discuss the limits of the analysis with us before submitting your exhibit.

Ignitable Liquid Analysis
Ignitable liquid analysis involves determining the presence of ignitable liquid residues (ILR) in the sample. If ILR is detected, it is classified according to its chemical composition. Vehicle Fluid Analysis
Vehicle fluid analysis involves an examination of samples from motor vehicles and mobile plant. The system from which the fluids most likely originated can be ascertained based on their chemical composition. Organic Oil and Fat Analysis
Organic oil and fat analysis involves determining the presence of any animal or vegetable oils or fats in the sample. If residues are detected, their tendency toward self-heating is reported. Physical Evidence Examination
Physical evidence examination involves the examination of debris and other fires-affected items. Other- Please specify:

Exhibits for Submission

Item 1

Job Reference

Exhibit Number

Collection location

Collection date

Description of exhibit (i.e. type of material, condition, etc.)

Exhibit Disposal

Please indicate below how you would like for us to dispose of your original exhibit and associated packaging. If you wish for us to retain and store the original exhibit, storage fees may apply. Note that extracts of fire debris samples are retained by our laboratory as a part of the analysis process. Reanalysis of sample data at a later date is therefore possible without the original sample.

Return to submitting agent

Retain and store

Destroy

Special instructions and/or additional analysis requirements:

ANALYSIS AGREEMENT

Your completed form will be sent to GKA Analytical Services staff, who will review your analysis request and carry out the analysis once your sample has been received. If you have not previously submitted samples to us, we will contact you to confirm your analysis needs before carrying out the analysis. If the scope of your request falls outside of our current capabilities, we will discuss alternative analysis options with you.

To ensure the most accurate test results are obtained, please ensure exhibits are collected and packaged appropriately. For guidance on packaging, please see our Exhibit Submission Guidelines. Our standard analysis turnaround time is 5 business days. However, complex or unusual analyses may take longer to complete. We will advise you of any delays in analysis.

I acknowledge that I have read and understood the above Analysis Agreement.