Fillable Chain of Custody (ERMI) (WP Engine)

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Chain of Custody (ERMI) (WP Engine)

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Page 1 of 1
228 Midway Lane, Suite B
Oak Ridge. TN 37830
www.assuredbio.com
info@assuredbio.com
Chain of Custody (ERMI)
Your Name:
AB Identifier (For Internal Use):
Address:
Project Name:
Project Date:
Job Number:
Phone:
E-mail:
Sample ID
Area Vacuumed
Time Vacuumed
Comments
1:
2:
Materials:
1 Dust Collector 1 Freezer Bag 1 Yard Stick or Tape Measure 1 Pair of Latex Gloves 1 Marker
1 Chain of Custody 1 Vacuum Cleaner 1 Roll of Masking Tape 1 Timer
Procedure for Dust Collection to be Submitted for ERMI Analysis
1.
Gather Dust Collection Materials & Equipment prior to 11. Turn on the Vacuum. 22. Vacuum inside the sampling area for 5 minutes.
sampling. 12. Set Timer for 5 minutes and start the Timer. 23. Carefully, remove the Dust Collection Device. This is done
2.
Put on Latex Gloves. 13. Vacuum inside the sampling area for 5 minutes. by holding the collection device facing up.
3.
Find the common living area within the house or building. 14. Look inside the device to confirm the visible presence of 24. Look inside the device to confirm the visible presence of
Within that area, identify the area with the highest traffic dust. (If there is no visible dust, vacuum the sampling area for 5 dust.
volume (preferably around the couch). more minutes.) 25. Place the caps back on both ends of the Dust Collection
4.
Using the Yard Stick or Tape Measure, measure out a 3ft. x 15. Record the total sample collection time in the box labeled Device. Replace the top cap first to prevent losing the collected
6ft. area and mark it with the Masking Tape. (If for some Time Vacuumed Room 1. sample.
reason the area is too small, mark off a total of 18 sq.ft. within 16. Move the sampling material to the second point of 26. Record the total sample collection time in the box labeled
the room.) collection (this should be a master bedroom or another area of Time Vacuumed Room 2.
5.
Record the total area marked for sampling in the box labeled high traffic). When moving between sampling areas, be sure to 27. Place the Dust Collection Device and the Assured Bio
Area Vacuumed Room 1. hold the Dust collector upright to avoid loss of dust collected. Chain of Custody inside a Freezer Bag.
6.
Plug the Vacuum Cleaner in and test that it is working 17. Using the Yard Stick or Tape Measure, measure out a 3ft. x 28. Submit the samples to Assured Bio.
properly. 6ft. area and mark it with the Masking Tape. (If for some
7.
Using a Marker, write a Sample ID Number on the Dust reason the area is too small, mark off a total of 18 sq.ft. within
Collection Device and record this information in the box the room.)
labeled Sample ID above. 18. Record the total area marked for sampling in the box
8.
Within the box labeled Sample Description Room 1, write in labeled Area Vacuumed Room 2.
the name of the first room sampled. 19. Within the box labeled Sample Description Room 2, write
9.
Remove the caps from both ends of the Dust Collection in the name of the second room sampled.
Device. 20. Turn on the Vacuum
10.
Remove the hose from the Vacuum and attach the Dust 21. Set timer for 5 minutes and start the timer.
Collection Device to it.
Please visit our website at www.assuredbio.com to view a demonstration of ERMI sample collection or to learn more about ERMI analysis.
Relinquished By: Date: Received By: Date:
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Chain of Custody (ERMI) (WP Engine)

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Completed 12 March 2022

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