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UTP CAL XRD Booking Form

This service requisition form requests powder X-ray diffractometer testing from the Centralized Analytical Laboratory for a sample, providing the applicant's name and project details, the proposed testing parameters and date, and notes on sample preparation and results collection. Upon approval by the applicant's supervisor and the department, the laboratory services will be provided and results collected on a CD-R, with the option to also collect customer feedback.

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Afif Izwan
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122 views1 page

UTP CAL XRD Booking Form

This service requisition form requests powder X-ray diffractometer testing from the Centralized Analytical Laboratory for a sample, providing the applicant's name and project details, the proposed testing parameters and date, and notes on sample preparation and results collection. Upon approval by the applicant's supervisor and the department, the laboratory services will be provided and results collected on a CD-R, with the option to also collect customer feedback.

Uploaded by

Afif Izwan
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Service requisition form Job No.

Centralized Analytical Laboratory (CAL)


Block P, Ground Floor
Powder X-Ray Diffractometer (XRD, Model: XPert3 Powder, PANalytical)
(Location : P-00-06)
Name :_________________________________________________ Company Name: .

ID No :______________Contact No:__________________________ Address: ...

Status : FYP MSc PhD RO Others:_________________ .. .

Department :ME EE CHE CV GPE FASD


Covenant of Applicant.
Project title :__________________________________________________
I . Have read and fully understood
Cost Center :_________________________________________________ and agreed to abide by the General Information,
Terms and Conditions Relating to Acceptance of
Supervisor :_________________________________________________ Projects for Testing and Laboratory Rules and
Regulation.
E-mail :__________________________________________________
Signature :
Sample Type : Powder only
IC NO :
*To be filled by internal customer only
No. Sample Name & Description Scan Range () Exposure Time (s/step) Step Size (/step) Existing Elements

1.
2.
3.
4.
5.
6.
Endorsed by:

________________________
(Supervisor/Project Leader)

FOR DEPARTMENT/CENTRE/SECTION USE:


Services applied can/cannot be provided. Proposed date of Testing :
Signature:
Name:
Designation:
Date:

Result & Sample Collected By:

Signature:
Name:
Date:
Customer Feedback form : Yes No

Note:
Please put your samples in glass vials with proper labeling.
Maximum of 6 samples can be submitted per request. Page 1 of 3
Results can be collected using a blank cd-r only. CAL_Aug2016
The sample volume should be able to fill in of amount 1.848 cm3.

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