Non-routine Cylinder Removal Request Form

This form is for requesting removal of non-routine gas cylinders only. DO NOT SUBMIT THIS FORM to request returns to GSS/Airgas/Praxair. Refer to the Procurement Supplier Information website for instructions on returning cylinders to these suppliers.

Provide building, room and other location information (e.g. storage locker, hood, etc.)

Photo should show condition of valve, contents, DOT markings

Drag and drop files here or

Provide supplier name or "unknown"

If empty, describe previous contents. Also list concentration (e.g. 90% nitrogen, 10 % oxygen)

Lecture: up to 3" dia. an 13" long or 4" dia. and 10" long Small: Up to 4" dia. and 24" long Med: Up to 12" dia. and 26" long Large: Up to 16" dia. and 56" long Extra Lrg: up to 20" dia and 64" long 1/2 Ton: up to 30" dia and 52" long or 20 " dia. and 82" long Ton: up to 24" dia. and 94" long or 30" dia. and 82" long

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