U.S. Geological Survey, Woods Hole Science Center

Archival Policies and Collections Database for the Woods Hole Science Center's Marine Sediment Samples 2007, Version 1.0

Chain of Custody Form

Sample Number: _____________

Collecting Scientist: __________________

Field Activity Number: ______________


Purpose for Sampling:

___

research

___

identification

___

other: ___________________________________________________


Custody of Samples is given to:

Name, title

___________________________________________

Institution

___________________________________________

Address

___________________________________________

City, State, zip

___________________________________________

Phone

_____________________

Email

___________________________________________


Approved by:

_________________________________________________________________________________
Core Curator Signature and Date

_________________________________________________________________________________
Chief Scientist Signature and Date

_________________________________________________________________________________
Borrower Signature and Date


Description of samples taken: locations of sampling and all alterations made to the sample(s):

1.

Amount Taken _______________ grams
Location of Sampling _______________ Section

2.

Amount Taken _______________ grams
Location of Sampling _______________ Section

3.

Amount Taken _______________ grams
Location of Sampling _______________ Section

4.

Amount Taken _______________ grams
Location of Sampling _______________ Section

5.

Amount Taken _______________ grams
Location of Sampling _______________ Section

 

For more than five (5) samplings, multiple forms must be completed

U.S. Geological Survey
Woods Hole Science Center
384 Woods Hole Road
Woods Hole, MA 02543