Gas Cylinder Order Form Requestor Information * Indicates a required field Name * Name First/Given First/Given Last/Family Last/Family Email * uNID * Position * Faculty Staff Student Other - Please explainOther - Please explain Delivery Information Building # * Please Select#83 = JFB#10 = South Physics#19 = INSCC Lab Room # * PI or Supervisor's Name * PI or Supervisor's Email * Special Delivery Instructions Materials Requested - Check all that apply Acetylene (Dissolved, 2.1, UN1001), (Item#: 100000). Size Type: Cu. Ft. Argon (Compressed Gas, 2.2, UN1006), (Item#: 100050). Size Type: K. Argon (Compressed Gas, 2.2, UN1006, Ultra High Purity (UHP)), (Item#: 100070). Size Type: K Carbon Dioxide (Compressed Gas, 2.2, UN1013), (Item#: 100110). Size Type: 50 LB. Helium (Compressed Gas, 2.2, UN1046), (Item#: 100160). Size Type: 219 Cu. Ft. Helium (Compressed Gas, 2.2, UN1046, Ultra High Purity (UHP)), (Item#: 100190). Size Type: 219 Cu. Ft. Nitrogen (Compressed Gas, 2.2, UN1066, Ultra High Purity (UHP)), (Item#: 100280). Size Type: K. Nitrogen (Refrigerated Liquid, 2.2, UN1977), (Item#: 100290). Size Type: Liter. Nitrogen (Refrigerated Liquid, 2.2, UN1977, LX45 (Low Pressure)), (Item#: 100310). Size Type: LX45. Oxygen (Compressed Gas, 2.2, UN1072), (Item#: 100410). Size Type: K. Argon (Compressed Gas, 2.2, UN1006, 25% Co2, 75% Argon), (Item#: 100490). Size Type: K. Nitrogen (Compressed Gas, 2.2, UN1066, 5% H2, Balance Nitrogen, Unanalyzed), (Item#: 110040). Size Type: K. OtherOther Quantity * Chartfield to Charge Must be in this format: 01 - 00127 - XXXX - XXXXX - XXXXX, where "X" is a numeric character. Explicated Chartfield Format: 01 - 00127 - (Fund #) - (Activity or Project#) - (Account #) For questions contact the Accounting Office (203 JFB, or 801-587-7839). Business Unit - 2 digits * Org ID - 5 digits * Fund - 4 digits * Activity or Project - 5 digits for Activity, 8 for Project * Account - 5 digits * Additional Information To prevent any delays with your order, please ensure all the information listed above is correct and valid. Please allow at least 3-5 days from the date of submission for cylinders to arrive. **General Store's delivery dates are Tuesdays and Fridays. Orders must be submitted by 3:30pm the day before in order to be delivered the next day. Submit If you are human, leave this field blank. Δ
