The Home Experts, Inc

	Name Of Client	Phone #	Street Address	City	State/Zip Code
Date	Name of Sampler	Sample ID	Cost/Type of Test Requested	Comments	Results of Test
			$
			$
			$
			$
			$
		Total	$
Date Shipped	Shipped By	Date  Received	Received By

Please Print out.  Do not fill out on line.





Each 2 inch by 2 inch sample should be raped in tin foil and placed in a sperate plastic bag.The bag should be labeled with the location from which the sample is taken. The plastic bag should be put in a labeled larger plastic bag.
 

Note the type of test requested by inserting the cost of the test in the noted row.  $50.00 for each chamber test and
$150.00 for each Sulfur  test.  Please include a check for the total of all the test.  The Sulfur test is sent to a Lab as we are not a laboratory.

The Chamber test will heat the sample to increase the off gassing.  We will observe the amount of corrosion, if any
on a copper coupon and compare it with a copper coupon from a sample of domestic drywall tested the same way. 
This takes a few days.

The Sulfur test is a chemical test that identifies any elemental Sulfur (S8) in the sample.  S8 is believed to be the
 impurity in Corrosive Drywall that starts starts the chemical process that leads to the corrosion.

The Home Experts, Inc.  is not responsible or liable for any issue, liability or cost that results from analyzing these samples. 



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                  Signed by the Client                             Date