Western Australian Consolidated Regulations

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FORM FOR RESULT OF SAMPLE ANALYSIS REGULATIONS - SCHEDULE

The Health Act 1911

Section 189, Subsection 7

Form of Certificate to be given by an Analyst

To * ………………………………………………

        ………………………………………………

I, the undersigned, being an Analyst registered under the provisions of the above Act, do hereby certify that I received on the . . . . . . . . day of

………………………….. from †……………………………….. a sample of

………………………………………..



for analysis, which then


weighed ……………




measured ……………


and which bore the following marks ………………………………………., and declare the result of my analysis to be follows: — 

§ Observations:

As witness my hand this . . . . . . . . . . day of …………………………….

Analyst.

*         Here insert the name of the person submitting the article for analysis.

†         Here insert the name of the person delivering the sample.

‡         When the article cannot be conveniently weighed or measured, this passage may be erased or the blank left unfilled.

§         Here the analyst may insert, at his discretion, his opinion as to whether the mixture (if any) was for the purpose of rendering the article portable or palatable or of preserving it or of improving the appearance, or was unavoidable.

        In the case of a certificate regarding milk, butter, or any article liable to decomposition, the analyst shall specially report whether any change had taken place in the construction of the article that would interfere with the analysis.



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