PRO-LAB® - AS108 Asbestos Test Kit Registration
TEST LOCATION
Email report to:
First Name:
Last Name:
Test Address:
City:
County:
NJ Municipality (if applicable):
State:
Zip Code:
Phone Number:
TEST INFORMATION
Sample Collection Date:
Room Level:
Basement
1st Floor
2nd Floor
Other
Room Used For:
Living Room
Bedroom
Other:
Sample Description:
Ceiling Tile (1 layer)
Insulation (1 layer)
Joint Compound (1 layer)
Plaster (1 layer)
Popcorn Ceiling (1 layer)
Roofing Sheet (2 layers)
Floor Tile (2 layers)
Wall Board (2 layers)
Other:
By submitting this sample you authorize PRO-LAB and its affiliate partner representatives to contact you about your results.