PNRI - Irradiation Service Online Application

Please take note that this is for filing of application for irradiation service only.

Apply for Irradiation Service

Reminder:

Please apply for irradiation service at least five (5) calendar days before your preferred schedule.
Wait for the approval of your application through email before submitting your products/samples.

Service Details

*Service Type:

*Facility:

Please fill-in Customer Information

Please bring a valid ID when you visit PNRI

*Customer Name:

*Section/Division:

*Project Title:

*Project Leader:

*Institution/Company:

*Position in Company:

Private Government

*Company Address:

*Type:

*Email Address:

We will contact you through the email address you provide.

Telephone No:

*Mobile No:

Preferred Schedule

Selected schedule is subject for approval. Please deliver your samples on or two days before the Approved schedule.

Product Details

Product/Sample Details

*Name of Sample:

*Min. Dose (kGy):

*Max. Dose (kGy):

*Packaging Material:

*Purpose of Irradiation:

Special Instructions (Leave blank if none):

Type of System to be used: Cart Conveyor System (CCS) Liquid Handling System (LHS)

Name of Product	Manufacturing Batch/Lot No.	No. of Boxes/Bags	Unit Weight	Product Size (cm)
Name of Product	Manufacturing Batch/Lot No.	No. of Boxes/Bags	Unit Weight	Sample Label	No. of Sample	Volume of Sample (L)	Requested Dose (kGy)	Weight (g)	Dimensions (cm) Rectangular Cylindrical
Length	Width	Height		Sample Label	No. of Sample	Volume of Sample (L)	Requested Dose (kGy)	Weight (g)

1. Customer Information

Customer Name

-, - -

-

Mobile No.

-

Tel No.

-

Title of Project

-

Section/Division

-

Project Leader

-

Company

-

Position

-

Private/Government

-

Company Address

-

2. Request Details

Service Type

-

System Type

-

Name of Sample

-

Min. Dose

-

Max. Dose

-

Packaging Material

-

Preferred Schedule

-

Irradiation Purpose

-

Special Instructions

-

3. Product Details

3. Sample Details

Name of Product	Manufacturing Batch/Lot No.	No. of Boxes/Bags	Unit Weight	Product Size (cm)
Name of Product	Manufacturing Batch/Lot No.	No. of Boxes/Bags	Unit Weight	Length	Width	Height
Sample Label	No. of Sample	Volume of Samples (L)	Requested Dose	Weight (g)	Dimensions (cm)
Sample Label	No. of Sample	Volume of Samples (L)	Requested Dose	Weight (g)	Length	Width	Height

I HEREBY CERTIFY that the information provided in this Application is complete, true and correct to the best of my knowledge.

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