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Alkyl Container Return
First name:
Last name:
E-mail Address:
Phone Number:
Company name:
Country:
State:
City:
Region:
Cylinder Type
*
:
Please Select
ALKYLTAINER 9.0
ALKYLTAINER 8.1
ALKYLTAINER 8.0
ALKYLTAINER 7.0
ALKYLTAINER 6.1
ALKYLTAINER 6.0
ALKYLTAINER 5.1
ALKYLTAINER 5.0
ALKYLTAINER 4.1
ALKYLTAINER 4.0
Others
Cylinder Serial
*
:
Number of Cylinders
*
:
The valves are tight and sealed with blindflanges
*
:
Yes
No
The cylinder(s) in good physical condition
*
:
Yes
No
The IMO-labeling on the cylinder(s) is still the original that has been sent and has not been modified
*
:
Yes
No
The cylinder(s) is/are empty and uncleaned
*
:
Yes
No
For Uncleaned Cylinders:
The cylinder(s) filled with LANXESS material; No other product has been filled into the container.
Yes
No
Net/Gross Weight:
Net/Gross Weight: (net equals gross in case of empty tainer) If multiple cylinders are being returned please provide weight details in the comments field
KG
Net
Gross
Dangerous goods details in accordance to IMDG regulations
Proper shipping name:
UN Number:
IMO-Class:
Package-Group:
Customer Comments: