"Request for Dairy Analysis" - Prince Edward Island, Canada

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PEI Department of Agriculture
Request for
& Fisheries
Dairy Analysis
PEI Analytical Laboratories
23 Innovation Way
Charlottetown, PE C1E 0B7
(A) Sample Information
○ Cow Sample
○ Tank Sample
○ Processed Product
○ Other
○ Voluntary (complete all sections) Request made by: ○ Phone ○ Email ○ In Person ○ Other
○ Valacta (complete all sections ) sample ID’s not required if barcodes provided
○ Inspector (complete all sections)
Name:
Lab Tech required to receive samples
○ Plant Quarterly Testing (complete section A)
Lab Tech required to receive samples
Collection Time:
○ a.m. ○
Sample Date:
dd/mm/yy
p.m.
B) Requested Analysis
Test
# of Samples
Sample ID’s
○ Voluntary Antibiotic (SLBL, SL3, Tetra,
Sulfa)
○ IBC
○ Coliform Count (CC)
○ Standard Plate Count (SPC)
○ Preliminary Incubation Count (PIC)
○ Lab Pasteurization Count (LPC)
○ E. coli
○ Staphylococcus aureus
○ Butterfat/ Protein/Lactose
○ Somatic Cell Count (SCC)
○ MUN
○ Added Water
C) Client
Producer Number:
Producer Name:
Address:
Phone:
Fax:
Email:
Signature:
Date:
PEI Analytical Labs reserves the right to refuse samples which are not submitted in containers supplied by the
lab; damaged containers or samples containing foreign material.
Lab Use Only
Payment Received: ○ Yes ○ No
○ Cash
○ Cheque
○ Debit
○ Credit
Amount:
Date Rec:
Time Rec:
Temp:
S or N:
Tech:
Results Reported: ○ Phone
○ Fax
○ Email ○ Mail
Date Reported:
Tech:
Visit our homepage at:
https://www.princeedwardisland.ca/en/information/agriculture-and-fisheries/pei-analytical-laboratories-peial
C38130330 (Oct 2015)
PEI Department of Agriculture
Request for
& Fisheries
Dairy Analysis
PEI Analytical Laboratories
23 Innovation Way
Charlottetown, PE C1E 0B7
(A) Sample Information
○ Cow Sample
○ Tank Sample
○ Processed Product
○ Other
○ Voluntary (complete all sections) Request made by: ○ Phone ○ Email ○ In Person ○ Other
○ Valacta (complete all sections ) sample ID’s not required if barcodes provided
○ Inspector (complete all sections)
Name:
Lab Tech required to receive samples
○ Plant Quarterly Testing (complete section A)
Lab Tech required to receive samples
Collection Time:
○ a.m. ○
Sample Date:
dd/mm/yy
p.m.
B) Requested Analysis
Test
# of Samples
Sample ID’s
○ Voluntary Antibiotic (SLBL, SL3, Tetra,
Sulfa)
○ IBC
○ Coliform Count (CC)
○ Standard Plate Count (SPC)
○ Preliminary Incubation Count (PIC)
○ Lab Pasteurization Count (LPC)
○ E. coli
○ Staphylococcus aureus
○ Butterfat/ Protein/Lactose
○ Somatic Cell Count (SCC)
○ MUN
○ Added Water
C) Client
Producer Number:
Producer Name:
Address:
Phone:
Fax:
Email:
Signature:
Date:
PEI Analytical Labs reserves the right to refuse samples which are not submitted in containers supplied by the
lab; damaged containers or samples containing foreign material.
Lab Use Only
Payment Received: ○ Yes ○ No
○ Cash
○ Cheque
○ Debit
○ Credit
Amount:
Date Rec:
Time Rec:
Temp:
S or N:
Tech:
Results Reported: ○ Phone
○ Fax
○ Email ○ Mail
Date Reported:
Tech:
Visit our homepage at:
https://www.princeedwardisland.ca/en/information/agriculture-and-fisheries/pei-analytical-laboratories-peial
C38130330 (Oct 2015)
LAB USE ONLY
C38130330 (Oct 2015)
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