Non-Radioactive Material Shipping Form

Samples/Chemicals1

List all of the chemicals to be shipped. Name and quantity are required.
Chemical Name / Formula Quantity (mL, L, g or kg) Material Hazards
Non-Hazardous
(initial below)		 Hazardous2
(as defined by OSHA)		 Biohazardous
(BSL1 or BSL2)
kg

Please have one of the following initial this form BEFORE bringing your package to A100 for shipment:

Andrea Szakal ____________ Yamali Hernandez ____________ Steve Kline3 ____________

1A Health Physics release is required for any sample or piece of equipment that has been exposed to neutrons.
2 To determine if a material is hazardous as defined by OSHA, refer to section 2 of the SDS. If you do not have a SDS for your material or need assistance in determining if the material is hazardous, contact the NCNR Safety Office or the Laboratory Responsible for assistance. If the material is hazardous, a SDS must accompany the shipment.
3Contact Steve Kline only if Yamali and Andrea are not available.