Bottle Order

Step 1: Basic information

Today's Date*

First Name*

Last Name*

Company / Organization*

Email*

Phone Number*

Step 2: Project details

Project Name

Project Number

Project State

State if "Other"

Site Address

City

State

ZIP

PWS ID if applicable

Expected Job Dates

Start

Finish

Refer to Previous Bottle Order/Quote/Job. EAI #

Additional Instructions

Step 3: Delivery information

Date Needed

Bottle Delivery Options
EAI CourierI Will Pick UpUPSEAI Chooses

Delivery Address

Street Address

City, State, ZIP

State

ZIP

Provide Recipient Info if Different From Step 1

Recipient's First Name

Recipient's Last Name

Recipient's Phone Number

Step 4: Choose sample types

Sample Types (you can choose multiple)
Soil Water AirOther

Soil
Number of Samples

Analyses / Tests Needed

Water
Number of Samples

Analyses / Tests Needed

Air
Number of Samples

Analyses / Tests Needed

Other
Number of Samples

Analyses / Tests Needed

Field QC Bottles Needed?
YesNo

Questions / Comments

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Enter 4-Digit Code From Above*

Quick Resources

Holding Times & Preservation Card

Get our convenient holding times and preservation reference card.

Download

Short Hold Time Parameters Chart
Download our sample turnaround table guidelines.

Download

Download the Eastern Analytical, Inc. Reference Card.

Download

Chain of Custody Forms

Download one of our chain of custody forms.

Print version

Interactive version

Residential Drinking Water Information
Get our homeowner drinking water guide and residential chain of custody form.

View PDF’s