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Compressed Gas Order Form
* Required Fields
Contact Information:
* Name:
* Email:
* Department:
* Phone: (nnn-nnnn)
Billing Information:
* Fund:
* Org:
  Work Order:
Delivery Information:
* Where would you like your order delivered to?
(Please be specific with a Building and Room number.)
 
  When do you need the order? (mm/dd/yyyy)
  Number of empty tanks to pick up:
Gas Type Quantity
 ACETYLENE, 100+ CF
 ACETYLENE, 40 CF
 ACETYLENE, 75 CF
 ACETYLENE MC, 10 CF
 ACETYLENE, PRE-PURE, 99.6%
 ALPHA GAZ, 5% METHANE/BALANCE NITROGEN
 ARGON, 200 CF
 ARGON, UHP
 CARBON DIOXIDE, WELDING GRADE, 100 LB
 CARBON DIOXIDE, WELDING GRADE, 20 LB
 CARBON DIOXIDE, WELDING GRADE, 50 LB
 CARBON DIOXIDE, SIPHON TUBE, 50 LB
 COMPRESSED AIR, BREATHING QUALITY, 233 CF
 COMPRESSED AIR, ZERO GRADE
 HELIUM, 200 CF
 HELIUM, UHP, 244 CF
 HYDROGEN, 200 CF
 HYDROGEN, UHP
 METHANE, RESEARCH GRADE, 44 CF
 NITROGEN, 200 CF
 NITROGEN, 40 LB
 NITROGEN, UHP, 234 CF
 OXYGEN, 200 CF
 OXYGEN, 155 CF
 OXYGEN, 92 CF
 OXYGEN, 19 CF
 OXYGEN, MEDICAL, "D" CYL.
 OXYGEN, MEDICAL, 200 CF
 OXYGEN, RESEARCH GRADE
 OXYGEN, UHP, 200 CF
 P-5 GAS (ALPHA GAS 95%)
 P-10 GAS (ALPHA GAS 90%)
 P-10 GAS, UHP

For assistance or questions with this form, call 907-474-6779.

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Main Number: (907) 474-7000   |    Website Contact: 474-7346
Physical Address:  803 Alumni Drive, Fairbanks, AK        Mailing Address:   P.O. Box 757380, Fairbanks, AK 99775 - 7380

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