TESTING INFORMATION

Sample Name/Description(s)

(e.g. rootzone mix, etc.):

Sample Location/

Date Sampled:

Tests to be run (please circle): Particle Size Analysis Gravel Gradation Infiltration Rate Organic Matter

USGA Performance Evaluation Bunker Sand Evaluation Water Release Characterization Soil Texture

Sand Capping Evaluation Green Roof Densities Nutrients

Other test(s) (please specify):

SPECIFICATIONS *

Rootzone Specifications (please circle one): USGA Greens California Greens Sports Fields Green Roof

Synthetic Turf Fairways/Tees Bunker Sand Infield Skin Retention Basin Other**

Rootzone Depth (in.): Gravel Blanket Depth (in.):

Other Specifications or Testing Instructions:

Billing Party:

Billing Address:

P.O. Number (if applicable):

Primary Secondary

Phone Number: Phone Number:

Fax Number: Email Address:

Other parties

to receive results:

Signature of Billing Party:

Title: Date:

Please send this completed form in with each sample submittal to: Turf Diagnostics and Design

613 E. 1^st St.

Linwood, KS 66052 USA

Phone: 1-913-723-3700

* The specifications section of this form only needs to be completed with the first sample submittal for each project.

** At the start of each project, please include a copy of the materials/testing specifications, so that proper testing can be performed.