THE HSWAGATA BUDDHA TOOTH RELIC PRESERVATION MUSEUM
FOR INTERNAL USE ONLY
Template No.: T205
Template Title: Sample Packaging & Transport Checklist
Related Research Case IDs / Cluster: Cluster E – Science, Testing, Misinformation (E46–E65)
Linked Templates / Policies: T201 Sample Request, T202 Lab Pre-Screening, T203 MoU & Data Governance, T204 Chain-of-Custody Log, T206 Result Receipt
Date of form: ____ / ____ / ______
Prepared by / Role: _______________________
Office / Unit: ____________________________
Country / Location: _______________________
Confidentiality Level:
Internal only [ ] Restricted [ ] Sacred-Restricted / Sensitive
Use of this form (tick):
New case / action [ ] Follow-up [ ] Annual review [ ] Archive only
FIELDS (tick each item)
A) Item Identification (complete before packing)
Relic ID: ______________________________
Sample ID (if any): _____________________
Lab / destination name: ______________________________
Destination address (short): __________________________
Planned dispatch date/time: //____ : (24h)
B) Packaging Steps (do in order)
1. Clean handling and area
Clean work surface prepared [ ]
Gloves / mask used (if needed) [ ]
Tools and containers are clean [ ]
Two-person rule in place (if required) [ ]
2. Primary container
Sample placed in primary container [ ]
Primary container is strong and closes fully [ ]
Primary container label applied [ ]
Tamper seal applied to primary container [ ] Seal no.: __________
3. Secondary protection
Primary container put inside a secondary bag/box [ ]
Cushioning added (shock protection) [ ]
Secondary container sealed [ ] Seal no.: __________
4. Outer packaging
Outer box is rigid and undamaged [ ]
Inner contents cannot move (extra padding added) [ ]
Outer box closed and sealed [ ] Seal no.: __________
5. Photos and records
Photos taken of: labels [ ] seals [ ] packed box [ ]
Chain-of-custody entry completed (T204) [ ]
C) Labels (must be clear and correct)
Tick what is on the label:
Relic ID [ ]
Sample ID [ ]
Date collected [ ]
Collector initials [ ]
“Fragile” [ ]
“Keep upright” [ ]
“Do not open without authorization” [ ]
Any special handling note: ______________________________
Label check done by (name/role): ____________________ Date: //____
D) Temperature / Environment (tick and fill)
Temperature control needed? Yes [ ] No [ ]
If Yes: Required range: _______ °C to _______ °C
Method: Ice pack [ ] Gel pack [ ] Insulated box [ ] Other: ______
Humidity control needed? Yes [ ] No [ ]
If Yes: Desiccant [ ] Humidity indicator [ ] Other: _____________
“No X-ray / special screening request” needed? Yes [ ] No [ ]
Notes (short): __________________________________________________
E) Courier Details (complete fully)
Courier company / method: _________________________________
Courier contact name/phone: _______________________________
Tracking number: _________________________________________
Pick-up location: _________________________________________
Delivery location: ________________________________________
Planned pick-up date/time: //____ :
Planned delivery date/time: //____ :
Insurance confirmed (if required): Yes [ ] No [ ] Policy/Ref: ______
Escort required? Yes [ ] No [ ] If Yes, name(s): ________________
F) Emergency Plan (simple)
If delay happens, who is called first? __________________________
If seal is damaged, what do we do?
Stop and report [ ] Take photos [ ] Record in T204 [ ] Inform security [ ]Backup contact at lab: _______________________________________
G) Final Sign-off (before release)
I confirm the package is sealed, labeled, and recorded correctly.
Packed by (name/role/sign): __________________________ Date: //____
Witness / checker (name/role/sign): ____________________ Date: //____
H) Receipt Confirmation (fill when delivered)
Delivered date/time: //____ :
Received by (lab name/role/sign): ______________________________
Seal check at receipt: Intact [ ] Not intact [ ] (explain): ____________
Photos taken at receipt: Yes [ ] No [ ]
Chain-of-custody updated (T204): Yes [ ] No [ ]
