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Preferred Sampling Date:
Name of Company:
Main Address:
Site Address:
Name of Representative:
Designation:
Telephone No./Mobile No :
E-mail Address:
Previous Third Party Testing/Sampler:

 TYPE OF SAMPLING?

STACK EMISSION TESTING




Type of Source?
Parameters?
Number of units?

AMBIENT AIR MONITORING




Parameters?
Number of Stations?

WORK ENVIRONMENT MEASUREMENT (WEM)




Parameters?
Number of stations?

WATER / WASTE WATER TESTING




Parameters?