CALS Chemical Intake Form Please place a barcode sticker on your chemical bottle. Fill out the following fields regarding the new chemical. An example submission would look like this: Barcode # 015962 Chemical Supplier: VWR Chemical Name: Sodium phosphate dibasic anhydrous CAS # 7558-79-4 Product # 0404 Amount: 12kg bucket Location: Emerson - EM-G51 Faculty Name: Susheng Gan Submitter Name: Kelly Hanley Submitter NetID: klh54 Barcode # * The # on the barcode sticker. Chemical Supplier * Sigma, VWR, Fluka, etc. Chemical Name * Exactly as it is written on the bottle. CAS # Please include the CAS# if it is noted on the bottle. Product # * Catalog/Product # of the chemical. (Not the Lot #!) Amount * How much is in the bottle? 5g? 200ml? CALS Location * The room/area the chemical will be stored. Examples: BF-511; BF-511 RATED Flammables Cabinet; WING-B56 Fridge/Freezer. The Locations were defined with direct input from researchers. Any questions or changes to these designations, please contact Kelly Hanley (klh54) or 607-255-0955. Faculty Name * Submitter Name * The name of the person filling out this form. Submitter NetID * The NetID of the person filling out this form. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.