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(Name & Designation) (Office)

This document is a sample card used for government projects. It contains fields to identify project details like name, location, material type and quantity. It also includes information on who sampled and shipped the material, proposed tests, test results recipient, and billing details. The card is used to properly identify and track material samples sent for lab testing.

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Lyka Dinglasan Almacha
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43 views

(Name & Designation) (Office)

This document is a sample card used for government projects. It contains fields to identify project details like name, location, material type and quantity. It also includes information on who sampled and shipped the material, proposed tests, test results recipient, and billing details. The card is used to properly identify and track material samples sent for lab testing.

Uploaded by

Lyka Dinglasan Almacha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Appendix II – 1

Republic of the Philippines


OFFICE OF THE DISTRICT ENGINEER
Masbate II D.E.O
Dimasalang, Masbate

SAMPLE CARD (For Government Project)

Project :
______________________________________________________________
(Name) (City/Province)

Kind of material :______________________________________________________________


Sample identification :______________________________________________________________
Quantity represented :______________________________________________________________
Sampled at :______________________________________________________________
(Give accurate location possible)
Original Source :______________________________________________________________
Owner / Supplier :______________________________________________________________
Sampled by :________________________ _____________________ ________________
(Name & Designation) (Office) (Date)/ Signature
:________________________ _____________________ ________________
(Name & Designation) (Office) (Date)/Signature

Proposed use :______________________________________________________________


Test desired :______________________________________________________________
Governing Specification :_______________________________________________________________
Shipped by :________________________ _____________________ _______________
(Name & Designation) (Office) (Date)/Signature

:_______________________ _____________________ ________________


(Name & Designation) (Office) (Date)/Signature

Send Test Results to :______________________________________________________________


______________________________________________________________
(Mailing Address)
REMARKS :______________________________________________________________
Bill charged to :______________________________________________________________
Submitted by :___________________________________ __________________________
(Name) (Signature)

____________________________ __________________________________
(Office) (Mailing Address)

- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- - - -- -

Received by: ________________________________ Lab. No. :_______________________

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