Rutgers Environmental Health and Safety
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Report Isotope Order
Instructions for Completing Form
Isotope Information
Name
Authoree Number
Authoree Name
Purchase Order Number
Date Ordered
January
February
March
April
May
June
July
August
September
October
November
December
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Building
Room
Vendor
Isotope
C-14
Ca-45
Cr-51
Cl-36
F-18
H-3
I-125
I-129
P-32
P-33
S-35
*other
Amount
Unit
uCi
mCi
*If you specified an other isotope, then please give the isotope here
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