Fillable Radioactive Requisition Form (Montana Tech)

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Radioactive Requisition Form (Montana Tech)

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1300 W. Park Street | Butte, MT 59701 | mtech.edu | 406.496.4463
Radioactive Materials Requisition Form
Please provide all requested information, including the banner account number to which
the materials will be charged.
Authorized user:
Telephone:
Date of request:
Date materials required:
Vendor name:
Vendor telephone:
Building and room materials will be used in:
Banner index #:
Purchase order #:
Item description:
Quantity (specify micro or millicuries)
Catalog #:
Price:
Authorized user signature ____________________________________ Date _______________
Approved by RSO _________________________________________ Date _______________
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Radioactive Requisition Form (Montana Tech)

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Completed 24 July 2020

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