Intake Form: COVID-19 testing in municipal wastewater
* Required
GTID – Barcode number (located on form and sample tubes) *:
Customer’s identifier written on tube (if available) :
Name of the location where sample is taken *:
Address of the location where sample is taken :
Account Name *:
Site time zone *:
Population served by site :
Sampling method *:
Auto-Sampler Section
Start Date and time of Auto-Sampler sample collection *:
End Date and time of Auto-Sampler sample collection *:
Sample collection and processing information
Sample was maintained at 4ºC during sample collection/compositing (highly recommended, please mention in notes if not maintained): *
Sample was maintained at 4°C during sample storage and transport (highly recommended, please mention in notes if not maintained): *
Average influent flow over sampling period (MG/D):
Notes :
Name of person filling out this form *:
Uploaded samples:
| Edit | Submittted date/time | GTID | Customer Sample Identifier | Sample Location Name | Sample Location Address | Account Name | Site time zone | Population served by site | Sampling method | Start Date and time of Auto-Sampler sample collection | End Date and time of Auto-Sampler sample collection | Sample was maintained at 4ºC during sample collection/compositing | Sample was maintained at 4°C during sample storage and transport | Average influent flow over sampling period (MG/D) | Notes | Name of person filling out this form |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| {{new Date(sample.uploaded_dt).toString()}} | {{sample.a_1}} | {{sample.a_11}} | {{sample.a_2}} | {{sample.a_5}} | {{sample.a_12}} | {{sample.a_8}} | {{sample.a_9}} | {{sample.a_10}} | {{sample.b_1}} | {{sample.b_2}} | {{sample.c_1}} | {{sample.c_2}} | {{sample.c_3}} | {{sample.c_4}} | {{sample.c_5}} |