Document 6528292

Sample service with Qubit™
In:
Out:
1
Functional Genomics Laboratory, 255 Life Sciences Addition MC-3200, Berkeley, CA 94720-3200
Please contact jygchoi@berkeley.edu, Tel: (510) 642-1165, or Fax: (510) 642-1219
User Information
*UC Funding
Code/PO#:
Fund Manager Information
Name
Email
TEL
Name
Email
Dept./Inst.
P.I.
TEL
_____________________________________________________________________________
Biohazard sample
___ No
___Yes*
User’s
Human/Mouse/
Info about your
sample
Origin
Rat/Arabidopsis or
___________________
Tissue
type
Purity
Your estimate
sample name
FGL’s
(by NanoDrop or on
gel _____________
Volume
(>3.0µl)
1
2
3
A260/280 ___~ ____
4
5
A260/230 ___~ ____
6
RNA
DNA
[ ] ss (Single stranded)
[ ] ds (Double stranded)
7
[ ] ss (Single stranded)
8
[ ] ds (Double stranded)
Protein*
Note:
9
10
11
12
13
Date/
# of
samples
*Please contact FGL before submitting your samples if you have an infectious sample. **Please note that your samples will not
be processed without concentration and chart-strings (or PO#). We will charge for the number of chips used + 10 min labor for
maintaining Bioanalyzer.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
Send request to:
For Office Use Only:
Functional Genomics Laboratory
Attention: Y. (Justin) Choi
UC Berkeley
255 LSA MC-3200
Berkeley, CA 94720
AUCHI
Recharge account:
On-campus rate: Chip_____
+__x$4.00= _____
x$
= _____
Off-Campus Rate: Chip_____+__
Total:
_______
Financial Journal #____________date________
2
Your estimate
sample name
(by NanoDrop or
_________________
#
User’s
FGL’s
Volume (>3.0µl)