Environmental Dust Test Form

ENVIRONMENTAL DUST TEST AGREEMENT AND SAMPLE SUBMISSION FORM

Client Name:   Contractor Name:

WHEREAS

1. WHEREAS Client requires professional environmental dust sampling and laboratory analysis at the Site described below to evaluate contaminant presence, and Contractor is qualified to perform such sampling and analysis in accordance with accepted industry practice and applicable regulatory guidance.

2. WHEREAS the parties desire to set forth the terms under which Contractor will collect, handle, submit, and report laboratory results for dust samples collected from the Site, including payment, confidentiality, chain of custody, and governing law provisions.

TEST REQUEST AND SCOPE OF WORK

SITE AND PROJECT INFORMATION

Date of Intended Collection:   Requested Analyses:

SAMPLE COLLECTION AND CHAIN OF CUSTODY

Number of Samples Collected:   Sampler Name:

Weather / Surface Conditions at Time of Sampling:

LABORATORY HANDLING AND PRESERVATION

Sample Containers Used:

Preservation / Hold Time Requirements:

PAYMENT TERMS

Total Fee for Services: $   Payment Schedule / Milestones:

TERM AND TERMINATION

Term Start Date:   Term End Date:

Either party may terminate this Agreement for convenience upon days' prior written notice. Termination for cause may be immediate for material breach that remains uncured for 10 days after written notice specifying the breach. Client remains responsible for costs incurred through the effective date of termination, including sampling, analysis, and reasonable laboratory cancellation or storage fees.

CONFIDENTIALITY

Contractor shall maintain as confidential all Client-specific data, sample locations, analytical results, and associated reports, except to the extent disclosure is required by law, court order, or regulatory authority. Contractor will provide prior notice to Client of compelled disclosures where permissible. Confidential information shall not be used for marketing or third-party dissemination without Client's prior written consent.

LIMITATIONS, LIABILITY AND WARRANTIES

Contractor warrants that services will be performed in a competent and workmanlike manner consistent with prevailing industry standards. Except for the foregoing warranty, services are provided "as is" and Contractor disclaims all other warranties, express or implied. Contractor's liability for direct damages arising from Contractor's negligence or breach shall be limited to the total fees paid by Client under this Agreement. Contractor shall not be liable for consequential, incidental, or punitive damages, nor for damages arising from Client's failure to follow recommended handling or preservation procedures.

GOVERNING LAW

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of laws principles.

ENTIRE AGREEMENT

This instrument constitutes the entire agreement between Client and Contractor with respect to the services described herein and supersedes all prior proposals, agreements, or understandings, whether written or oral. Any amendment to this Agreement must be in writing and signed by both parties.

CERTIFICATIONS AND SAFETY

By submitting this form, Client certifies that the information provided is complete and accurate to the best of Client's knowledge; that Client has obtained any necessary permissions or access authorizations for sampling; and that Client acknowledges Contractor's safety requirements for site access. Client agrees to notify Contractor promptly of any hazardous conditions or the presence of regulated materials that may affect sampling or laboratory handling.

SIGNATURES

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