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Large Chemical Orders Form
Use this form when ordering 10 or more gallons of any bulk chemical. Please allow 24 hours for order completion. If you have a specific pick-up time, please let us know.
Name
*
Email
*
Index #
*
Department
*
Required to purchase certain chemicals.
Chemical Needed
*
Acetone (Tech) - UA15TG
Ethanol (100%) UE21TG
Ethanol (95%) UE20TG
Hexanes (Tech) UH26UG
Methanol (USP) UM30UG
Pump Oil (Medium Viscocity) YO20UG
Iso-Propanol (Tech) UP64UG
Amount Needed
*
Please specify how much of each chemical you will be ordering.
Drop off and Pick-up time
*
When will you be dropping off your empty containers? When do you want to pick-up your refills?
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