The Campbell Microanalytical Laboratory

Department of Chemistry
University of Otago
Union Place
P.O. Box 56
Dunedin
New Zealand

Tel: (64)-3-479-7886
Fax: (64)-3-479-7906

Email: microlab@chemistry.otago.ac.nz

ANALYSIS REQUEST
(to accompany sample for analysis)

Sample No: ..............................................................................................

Report to: .................................................................................................

.................................................................................................................

.................................................................................................................

.................................................................................................................

Analyses desired: ......................................................................................

M.P. (°C) ......................   B.P. (°C) ..................  @ ....................  mmHg

Hygroscopic?        Volatile?       Sublimes?        Explosive?

Other elements present: .............................................................................

Type of compound: ...................................................................................

N present as: ............................................................................................

 

 

Composition:

C .......................................................

H .......................................................

N .......................................................

Cl, Br, I, F..........................................

S ........................................................

Structure, if known:

 

Drying instructions, etc. (temp., pressure): .................................................

.................................................................................................................

 

Date: ...................................     Signed: ....................................................