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Analytical Service Request Form

SHIVA Technologies New York - An Operating Unit of Evans Analytical Group LLC

Please complete the form below. You can also download and Fax the PDF version of this form and fax it to (315) 431-9800. If you have any questions, please contact SHIVA Technologies at (315) 431-9900 or email .

* Indicates Required Field  
 

Submitted by
First Name*:
Last Name*:
Company Name*:
Telephone*:
Fax*:
E-mail*:
     
 

Order Information

PO Number:  
Number of Samples *:
Material/Matrix*:
Rush Service? YES (Additional fees apply)  
Return Samples*? YES NO (Additional fees apply)
Report Delivery Method*: Fax Email Fax and Email
Job/Quote Number  
 

Analysis Information
 

GDMS

   
Select one: Bulk Analysis
Depth Profile
Select one: Full Scan
Single Scan (1 element - please specify below)
Partial Scan (up to 25 elements - please specify below)
 
Li Sc Se In Gd Ir
Be Ti Br Sn Tb Pt
B V Rb Sb Dy Au
F Cr Sr Te Ho Hg
Na Mn Y I Er Tl
Mg Fe Zr Cs Tm Pb
Al Co Nb Ba Yb Bi
Si Ni Mo La Lu Th
P Cu Ru Ce Hf U
S Zn Rh Pr Ta  
Cl Ga Pd Nd Re  
K Ge Ag Sm Os  
Ca As Cd Eu W  
     
 

IGA

    
Select all which apply: H
C
N
O
S
     
 

ICP

   
Select One: ICP/OES ICP/MS LA-ICP/MS
     
Select all which apply:  
Li Sc Se In Gd Ir
Be Ti Rb Sn Tb Pt
B V Sr Sb Dy Au
Na Cr Y Te Ho Hg
Mg Mn Zr Cs Er Tl
Al Fe Nb Ba Tm Pb
Si Co Mo La Yb Bi
P Ni Ru Ce Lu Th
S Cu Rh Pr Hf U
K Zn Pd Nd Ta  
Ca Ga Ag Sm Re  
  Ge Cd Eu Os  
  As     W  
 
 
In this space please provide any new contact information or other comments that will help us process your samples (purpose of analysis, sample identifications, lot numbers, expected contaminations, specs, etc.).