Kalassay Group - Online Assay Request Form

Online Assay Request Form

Assay requests may be be submitted to any of our 4 laboratories using this form.

Please include sufficient detail where necessary.

Select a Laboratory

Perth	Kalgoorlie	Leonora	Kendari
10 Elmsfield Road, Midvale, WA 6056	20 Cunningham Road, Kalgoorlie, WA 6430	Lot 1105 Rajah Street, Leonora, WA 6438	44th R. Suprapto Street, Kendari, Indonesia 93111
Ph: (08) 9250 6122 Fx: (08) 9250 6133 email: perth@assay.com.au	Ph: (08) 9091 7227 Fx: (08) 9091 7228 email: kalgoorlie@assay.com.au	Ph: (08) 9037 6160 Fx: (08) 9037 6270 email: leonora@assay.com.au	Ph: +62-401-325180 Fx: +62-401-325221 email: kendari.lab@inspectorate.co.id

Sample Delivery Details
Laboratory Transport
Sample Pickup Location:
In Transit
Transport Company: Con Note #:

Sample Number Strings

Please limit sample batches to 200 - 250 wherever possible.
Large sample batches take much longer to process
and have a direct impact on batch turnaround time.

Excessively large sample batches which require division into sub-batches,
will incur additional charges and will take longer to be completed.

We are having problems with transferring files in .xls format.
Please send spreadsheet files as .csv format.
We will remove this message when the issue has been resolved.
We apologise for the inconvenience. Thank you.

Upload Prepared File (max size 500Kb)

Or, Enter sample strings below:

to to to to to to to to to to to to to to to to to to to to

Analysis: (Elements in priority order)

Determinations

Number of samples:

No. of determinations:

Sample Preparation

Crush and split to obtain:

Store Crushed Rejects:

Yes No Period

Pulverize:

Store Pulverized Sample:

Yes No Period

Additional Data on Sample

Charge To

Company Name:
Company Address:
Company Phone Number:
Purchase Order Number:
Company Officer:
Data returned to:
Other Data Copies to:

Hazardous Materials Warning !!!

Hazardous materials are regarded as including, but not restricted to:

» Asbestos or other dangerous fibrous materials.
» Radiation sources.
» Mercury.
» Poisonous compounds.

Please indicate here if the samples listed on this sheet are known or suspected to contain any hazardous materials. This advice represents a statutory declaration.

	Radioactive
	Fibrous» Specify mineral(s)
	Mercury
	Other » Please specify

Samples are accepted for analysis, subject to our standard terms and conditions

Thank you for entrusting your valuable samples to The Kalassay Group

W.A. Chamber of Minerals & Energy

Home	Corporate Information	Terms & Conditions	Standards
Perth Assay Laboratory 10 Elmsfield Road, Midvale, Western Australia 6056 map Ph: +61 (0) 8 9250 6122 Fx: +61 (0) 8 9250 6133 perth@assay.com.au	Kalgoorlie Assay Laboratory 20 Cunningham Road, Kalgoorlie, Western Australia 6430 map Ph: +61 (0) 8 9091 7227 Fx: +61 (0) 8 9091 7228 kalgoorlie@assay.com.au	Leonora Assay Laboratory Rajah Street, Leonora, Western Australia 6438 map Ph: +61 (0) 8 9037 6160 Fx: +61 (0) 8 9037 6270 leonora@assay.com.au	Fair Trading Code of Practice