Chem 265 – Irradiation Request Name of Requestor(Required) First Last Name of Requestor 2 First Last Name of Requestor 3 First Last Email(Required) Email 2 Email 3 Chem 265 Experiment Irradiation is Requested for:(Required) Experiment #6 Experiment #7 Experiment #9 Other Requested Irradiation PositionD8 (rotator)D8 (tuna can)D9 (rotator)D9 (tuna can)AIIF-1 (tuna can)AIIF-2 (tuna can)AIIF-3 (tuna can)C8 (rotator)C8 (tuna can)E8 (rotator)E8 (tuna can)E9 (rotator)E9 (tuna can)F8 (tuna can)H2 (tuna can)H3 (tuna can)H4 (tuna can)H5 (tuna can)H6 (tuna can)H7 (tuna can)Not sure (best available)BeamlineC9 (tuna can, blocked)D9 (tuna can, blocked)E9 (tuna can, blocked)F9 (tuna can, blocked)Z2 (tuna can)Z3 (tuna can)Requested Reactor Power 1 MW 100 kW 10 kW Other Date of Requested Irradiation(Required) MM slash DD slash YYYY Requested Irradiation Length (Hours : Minutes : Seconds)(Required) Total Number of Samples(Required)Samples Packaged in:(Required) 2/5 Dram Vials Sample Information(Required)Sample NameSample Mass (mg)Elements that Are or May Be PresentExpected Activity (uCi) Add RemoveNotes/Comments Δ