CAL/QP03/F01D

`` Job No.:

Internal Billing Form

(For customer in UTP only)

To be filled out by internal customer:

Service Required :  Field – Emission Scanning Electron Microscope (FESEM)

(tick one)  Transmission Electron Microscope (TEM)
 Surface Area Analyzer and Porosimetry System (SAP)
 X-Ray Photoelectron Spectrometer (XPS)
 Gas Chromatography Mass Spectrometer (GC-MS)
 Liquid Chromatography Mass Spectrometer (LC-MS)
 Raman Spectrometer
 Universal Scanning Probe Microscope (USPM)
 In-Situ Fourier Transform Infra Red Spectrometer With High Vacuum Purge System (FTIR)
 Particle Size and Zeta Potential Analyzer (Particle Size)
 Atomic Absorption Spectrometer (AAS)
 Customized Gas Analyzer
 Simulated Distillation GC (SimDist)
 Temperature Programmed Desorption, Reduction and Oxidation (TPDRO)
 X-Ray Diffraction (XRD)
 Others: _________________________________

Cost Center/ Department Code : _________________________________

Total cost estimated : _________________________________

(Refer to Table 1,page 3)

Requested by (Supervisor/Project Leader): Endorsed by (Manager/Lab Exec/Exec if using fund from department

Signature: Signature:
Name: Name:
Designation: Designation:
Date: Date:
Tel. No:

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