AXIS INSPECTION SOLUTIONS

SAMPLE RECEIPT FORM

Sample supplied by
(Name & Contact details of
the Customer)

Date of receipt
Type of test
Sample Description
Sample Identity
Specific test required Chemical/Mechanical /Metallurgical/Corrosion/NDT
Feasibility of testing Possible/Not possible

Test Method ASTM, IS, ASME, AWS, ISO, EN:

Accepted if Appropriate
Customer suggested method

Required Not required

Statement of Conformation
Decision rule for conformation UOM to be considered UOM Not to be considered
as per 7.8.6.1of Quality Manual
Test witness Required Not required

Approximate delivery schedule

GST details

Name of the customer contact

person & contact number

The above information’s are true to best of our knowledge and accepted mutually.

Signature of the customer Signature of the sample receiver