LOCATION OF PROPERTY
Dept
NAME AND ADDRESS OF REPORTING AGENCY
FARMINGDALE STATE
PROPERTY CONTROL
FARMINGDALE, NY 11735
Building
Room No
REPORT OF SURPLUS (Usable) PERSONAL PROPERTY
Department surplusing equipment should fill out all sections
pertaining to equipment.
Contact Person
Phone No
The personal property listed below is no longer required by this agency. For further information about this
property contact:
Phone No:
Name:
ITEM
DESCRIPTION
HAZARD
CODE*
NO. OF
ASSET NO.
SERIAL NO.
CONDITION
Date:
Dept Head Signature:
* HAZARD CODE: B = Biological
C = Chemical
NOTE: SHOULD THE REMOVAL OF THIS EQUIPMENT REQUIRE ANY
SPECIAL HANDLING OR EXPEDITING, PLEASE EXPLAIN AND
JUSTIFY.
R = Radiation
N/A = Not Applicable
If Hazard Codes B, R, or C are used, contact Environmental Health & Safety (2-641 0) prior to forwarding
form to Property Control.
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