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Analysis Request Form - chemical composition measurement

Fill in the number of samples to be analyzed and press the update button:
Number samples to test:
composition
    Click here for explanation about the types of INAA analysis
  Description of sample(s):
 
                      Your sample code / Estimated values / Comments / Elements to be determined
 
  Recommended storage:

refrigerated
dry
ambient
other?

     
  Properties of the sample(s): dry
needs to be dried at (max) degrees Celsius
other?
 

 

  Safety precautions: no safety precautions necessary
toxic
acid
other?
     
  Urgency:
Customer information:
  Name
 
*(mandatory field)
    mr. mrs.
  Company
  Address
 
  Phone
  Fax
  E-mail
 
*(mandatory field)
  Your order number / reference
 
*(mandatory field)
  VAT number (Dutch: BTW nummer)
*(mandatory field)
  Invoice address, if different from above:
 
We will store samples for three months, after which the samples will be destroyed. If you want us to return your samples, please tick the checkbox. Shipping costs will be charged.

 
Tick the checkbox to agree to the General Terms and Conditions of Delft Solids Solutions B.V.
*(mandatory field)
  Please send the printout of this form together with your samples.
   

signature (on printout): ..........................................................................

For users of Apple/Mac based computers:
please press on your keyboard 'apple-' and p-key' at the same time to print this page

Liability: Delft Solids Solutions B.V. total liability is limited to replacement, or refund of an amount, which will not exceed the sales price of services, rendered.
In no case Delft Solids Solutions B.V. will be liable for consequential or special damage even if Delft Solids Solutions has been advised of the possibility of such damage.

Confidentiality: Delft Solids Solutions B.V. respects our clients' needs regarding confidentiality; all results will be treated as such.

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02-01-2012
IUPAC technical report on the characterization of porous materials
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Delft Solids Solutions B.V. | Rotterdamseweg 183C | 2629 HD Delft | The Netherlands | Phone: +31 (0) 15 26 825 16