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 Argon - $71.07 ea, Size 200, Industrial Grade, CGA 580 (Part #: AR 200) Argon (UHP) - $104.63 ea, Size 200, Ultra High Purity, CGA 580 (Part #: AR UHP200) Helium - $263.00 ea, Size 200, Industrial Grade, CGA 580 (Part #: HE 200) Helium (UHP) - $307.50 ea, Size 200, Ultra High Purity, CGA 580 (Part #: HE UHP200) Nitrogen - $75.50 ea, Size 200, Ultra High Purity, CGA 580 (Part #: NI UHP200) Nitrogen (5% H2) - $111.89 ea, Size 200, Industrial Grade Mix, CGA 350 (Part #: NI HY5200) Nitrogen (LN2) - $261.75 ea, 180 Liter Liquid Dewar (XL-45), 230 PSI (Part #: NI 180LT230) Nitrogen (LN2) - (CO) Customer Owned, 180 Liter Liquid Refill (XL-45) Nitrogen (LN2) - (CO) Customer Owned, 230 Liter Liquid Refill (XL-230) Nitrogen (LN2) - Sold by the liter 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 and up to a full week for dewar refills. * Airgas delivery days are Tuesday - Thursday. Next-day rush orders must be submitted by 1:00pm the day before. ** Deliveries cannot be guaranteed for specific dates. Submit If you are human, leave this field blank. Δ
