Sample Le Duong internal form
LE DUONGCASHEW

SAMPLE — NOT ISSUED

Related certificate service: Heavy metals (Pb, Cd, Hg, As)

Heavy Metals Information Statement — Le Duong Internal Form

Order and product information

Form reference
Completed after order review
Issue date
Completed after order review
Buyer / consignee
Completed after order review
Contract / PI reference
Completed after order review
Product / grade
Completed after order review
Lot / batch
Completed after order review
Quantity
Completed after order review
Country of origin
Completed after order review

Service-specific information

Sampling reference
Completed after order review
Analysis method / reference
Completed after order review
Lead (Pb)
Completed after order review
Cadmium (Cd)
Completed after order review
Mercury (Hg)
Completed after order review
Arsenic (As)
Completed after order review
Result unit
Completed after order review
Agreed specification
Completed after order review
Internal conclusion
Completed after order review

Review and release

Prepared by
Completed after order review
Reviewed by
Completed after order review
Approved by
Completed after order review
Release status
Completed after order review