Airgas Cylinder Return Form

Airgas Cylinder Return Form

Please provide as much detail as possible to facilitate the identification and removal of Airgas Cylinders

Requester*

Required*

Requester Email Address*

Required*

Cylinder Barcodes

DLCIs are strongly encouraged to include each cylinder’s barcode number.

This is the only unique identifier that will allow MIT to accurately track the cylinder through the return process so that your DLCI is properly credited for its return and removed from the monthly Airgas bill file.

If you are unsure of where to find the cylinder barcode, please see [Barcode Sticker Examples] for examples or contact your EHS coordinator to assist you.

Barcode Number (If Available)

Multiple Barcodes separated by comma are accepted in this field

Cylinder Location Information

Building Number*

Required*

Room Number*

Required*

Part Number*

Required*

Quantity*

Required*

Additional information

Date Cylinder(s) is Ready for Pick-up

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