BORANG TEMPAHAN (RADAS/PERALATAN/BAHAN · PDF fileFAKULTI PERGIGIAN UITM. TEL : 03-61266100 FAX: 03-61266103 * Borang ini PERLU dihantar 3 hari sebelum tarikh penggunaan

FAKULTI PERGIGIAN UITM. www.dentistry..uitm.edu.com.my TEL : 03-61266100 FAX: 03-61266103

* Borang ini PERLU dihantar 3 hari sebelum tarikh penggunaan. (DO SUBMIT this form 3 day before date of use) ** Maklumbalas dalam tempoh DUA (2) hari. (Will be replied TWO (2) days after form submitted)

BOR.UiTM.FPG.PJI.(MAK).05

BORANG TEMPAHAN (RADAS/PERALATAN/BAHAN

PAKAIBUANG) SETOR/MAKMAL Booking Form (Apparatus/Equipment/Disposable items)

1. Nama Pemohon : ________________________________ Applicant’s Name

2. No. Pekerja / Pelajar / I.C : ________________________________

Staff / Student I.D / I.C

3. Tujuan Penggunaan : ________________________________

Purpose

________________________________

4. Tarikh Penggunaan : ________________________________

Date of Use

5. Durasi Penggunaan : ________________________________

Usage Duration

6. Nama Penyelia (Penyelidikan) : ________________________________

Supervisor’s Name (Research)

*Senarai radas rujuk lampiran 1

Tandatangan Pemohon Applicant Signature

______________________________ ( ) No. Telefon / Phone No. :

(Untuk Kegunaan Pejabat) ( For Office Use Only)

Application Accepted / Not Accepted On The Date

Permohonan diterima / tidak diterima

Science Officer Signature,

________________________

( Stamp & Sign )



LAMPIRAN 1

SENARAI BAHAN PAKAI BUANG/RADAS

NO PERKARA SILA (√) KUANTITI

BAHAN PAKAI BUANG

1. DISPOSABLE PASTEUR PIPETTE

2. PARAFILM

3. YELLOW TIPS EPPENDOFT 200UL

4. TIPS STANDARD BULK 100-5000UL

5. TIP 0.1-10UL

6. BIOHAZARD PLASTIC 18 X 18.5

7. BIOHAZARD PLASTIC 700 MM X 700MM

8. BIOHAZARD PLASTIC 100 MM X 100MM

9. AUTOCLAVABLE DISPOSABLE BAG FC-BIOS

10. MICROCENTRIFUGE TUBE 1.5ML WITH CAP

11. COLLECTION TUBE 1.5ML

12. FILTERPAPER WHATMAN NO 1 & 2

13. PIPETTE TIP 1000UL (BLUETIPS)

14. URIN PROBER

15. WOODEN TONGUE DEPRESSOR (ADULT)

16. MICROSCOPE SLIDE

17. COLE PARMER SMALL WEIGH DISH

18. COLE PARMER MEDIUM WEIGH DISH

19. CRYOGENIC VIALS

20. HAND SANITIZER REFILL

21. HAND WASH REFILL

22. SAFE LOCK TUBE 0.5ML

23. CENTRIFUGE TUBE 50 ML

24. CENTRIFUGE TUBE 15 ML

25. MICROCENTRIFUGE TUBE 1.7 ML

26. 6 WELL CELL CULTURE CLUSTER




30. SYRINGE 1 ml




31. SYRINGE 3 ml

32. SYRINGE 20 ml

33. SYRINGE 10 ml

34. NEEDLE 21 G

35. NEEDLE 23 G

36. ALCOHOL SWAB

37. GLASS SLIDE

38. COVER SLIP

39. PETRI DISH

40. EDTA TUBE (LAVENDER) - PLASMA

41. URIN PROBER

RADAS (KACA)

1. BURET 100ML (PYREX)

2. BURET 500ML

3. BURET 50ML

4. MICROSCOPE SLIDE

5. LABORATORY BOTTLE 50ML





10. FUNNEL 75MM

11. FUNNEL LONG

12. FUNNEL 80MM

13. FUNNEL (BIG)

14. MORTAR & PESTLE

15. GRADUATED CYLINDER 1000ML

16. GRADUATED CYLINDER 500 ML

17. GRADUATED CYLINDER 250ML

18. VIAL BOTTLE 10ML

19. CONICAL FLASK 2000ML










26. UNIVERSAL BOTTLE

27. GLASS COPLIN STAINING JAR

28. VOLUMETRIC PIPETTE

29. LABORATORY BOTTLE(WHITE)

30. LABORATORY BOTTLE(DARK)

31. MEASURING CYLINDER HEX SPOUNTED 500ML

32. MEASURING CYLINDER PLAST FOOT 250ML

33. VOLUMETRIC FLASK 500ML

34. VOLUMETRIC FLASK 1000ML

35. GLASS DROPPER

36. BEAKER 1000ML

37. BEAKER 100ML

38. BEAKER 600ML

39. BEAKER 10ML

40. BEAKER 250 ML

41. TEST TUBE 10 X 75ML

42. TEST TUBE 12 X 75ML

43. TEST TUBE 18 X 150 ML

44. TEST TUBE 17 X 125MM

45. TUBE TUBE 10 X 152MM

RADAS (PLASTIK)

1 BEAKER WMEG 2000ML

2 BEAKER WMEG 1000ML

3 BEAKER WMEG 500ML

4 BEAKER WMEG 250ML

5 BEAKER WMEG 50ML

6 CONTAINER 20ML

7 PLASTIC STRAINER

8 FUNNEL (SMALL)

9 FUNNEL(BIG)




10 MEASURING JUG 2000ML

11 MEASURING JUG 1000ML

12 CONICAL FLASK 2000ML






18 GRADUATED CYLINDER 2000ML







RADAS/LAIN-LAIN

1. SPIN BOX STIRRING BAR

2. BOTTLE BRUSH (LONG)

3. BOTTLE BRUSH (SMALL)

4. STAINLESS STEEL SPATULA SPOON

5. STAINLESS STEEL SPATULA FORCEO SHARP 150MM

6. TEST TUBE RACK

7. STERILE AEROSOL PIPETS TIPS 10UL PIPETTOR

8. STERILE AEROSOL PIPETS TIPS 200UL PIPETTOR

9. DEB INSTANT FOAM DISPENSER

10. PLASTIC SHOVELS 1000ML

11. PLASTIC SHOVELS 500ML

12. LABORATORY TROLLEY (2 TINGKAT)

13. METAL TRAY

14. PEDAL CLINICAL WASTE BIN

15. CONTAMINATED SHARP BIN 5 LITER

16. CONTAMINATED SHARP BIN 10 LITER

17. LIQUID NITROGEN (UNTUK PENYIMPANAN)

18. MICROPIPPETE 100 – 1000ul






21. MICROPIPPETE 0.5 – 10ul

22. BULB

23. PARAMOUNT BLADES

24. CUVVETE

MEDIA (MICRO)

1. MEDIA OXOID

2. BRAIN HEART INFUSION AGAR 500G (OXOID)

3. BRAIN HEART INFUSION (OXOID) 500G

4. NUTRIENT AGAR (OXOID) 500G

5. TCBS CHOLERA MEDIUM (OXOID) 500G

6. MACCONKEY AGAR (OXOID) 500G

7. SIMMONS CITRATE AGAR (OXOID) 500G

8. MUELLER - HINTON AGAR (OXOID) 500G

9. C.L.E.D MEDIUM (OXOID)

500G

10. COOKED MEAT MEDIUM (OXOID) 500G

11. BACTERIOLOGICAL PEPTONE (OXOID) 500G

12. SABAURAUD DEXTROSE AGAR (OXOID) 500G

13. TRIPLE SUGAR IRON AGAR (MERCK) 500G

14. TCBS AGAR(MERCK) 500G

15. NUTRIENT BROTH (MERCK) 500G

16. NUTRIENT AGAR (MERCK) 500G

17. MACCONKEY AGAR (MERCK) 500G

18. MR-VP BROTH (MERCK) 500G

19. MUELLAR-HINTON (MERCK) 500G



CHEMICAL

NO

KATEGORI JENAMA NAMA SILA (√) KUANTITI

1. CARCINOGEN SIGMA

TRYPAN BLUE SOLUTION (0.4%) 100ML

2. R&P CHEMICALS TRYPAN BLUE 0.2% AQUEOUS SOLUTION 500ML

3. SIGMA THIAZOLYL BLUE TETRA ZOLIUM BROMIDE 5G

4. SIGMA DEXAMETHASONE MINIMUM 98% HPLC 25MG

5. PAA

GEMTAMAICIN 10MG

6. SIGMA TRYPSIN TYPE XII-S FROM BOVINE PANCREAS 50MG

7. SIGMA TRYPSIN FROM BOVINE PANCREAS 100MG

8. SIGMA

HYDROCORTISONE 5MG

9. -

MTT SOLUTION

10. -

ANTI MICROBIAL HANDSOAP 1L

11. SIGMA

CRYSTAL VIOLET 25G

12. PROMEGA

MTT SOLUTION 20 ML

13. HAZARDOUS SIGMA

PROPIDIUM IODIDE SOLUTION 10ML

14. SIGMA

SODIUM PYRUVATE 100ML

15. PAA

TRYPSIN 100ML

16. SIGMA

TRYPSIN 100ML

17. SIGMA RIBONUCLEASE A FROM BOVINE PANCREAS 50MG

18. SIGMA 4-NITROPHENYL PHOSPHATE DISODIUM SALT 5G

19. SIGMA NITROTETRAZOLIUM BLUE CHLORIDE 1G

20. SCIENCE CELL DULBECCO’S MODIFIED EAGLE MEDIUM 500ML (DMEM)

21. SCIENCE CELL DULBECCO’S MODIFIED EAGLE MEDIUM 1000ML (DMEM)

22. SIGMA DULBECCO’S MODIFIED EAGLE MEDIUM NUTRIENT MIXTURE F-12 HAM 500ML

23. SIGMA DULBECCO’S PHOSPHATE BUFFERED SALINE 500ML

24. SIGMA M 16 MEDIUM (EMBRYO TESTED) 100ML

25. -

PBS

26. SCIENCE CELL ORAL KERATINOCYCTE MEDIUM (OKM) 500ML

27. CALBIOCHEM

PROPIDIUM IODIDE 100ML

28. GIBCO

PEN STRIP

29. SIGMA

FETAL BOVINE SERUM 100ML

30. JR SCIENCE INC FETAL BOVINE SERUM U.S ORIGIN 500ML

31. PAA FETAL BOVINE SERUM MYCOPLEX 500ML

32. SIGMA

EDTA 500MG

33. SIGMA MAGNESIUM CHLORIDE HEXAHYRATE 500MG

34. SIGMA

DL-DITHIOTHREITOL 5G

35. SIGMA

TRITON X-100 100ML

36. SIGMA

NEUTRAL RED 25G

37. SIGMA

ASIATIC ACID 500MG

38. FLUKA

ASIATICOSIDE 5MG



CHEMICAL

39. PROMEGA

SOLUBILIZATION SOLUTION 100ML

40. PAA

AMPHOTERICIAN B 100ML

41. SCIENCE CELL

FBS 10ML

42. SCIENCE CELL

FGS 10ML

43. SCIENCE CELL

P/S SOLUTION

44. R & D SYSTEMS MICROPLATE HUMAN BDNF IMMUNOASSAY

45. PROMEGA

DYE SOLUTION 15ML

46. SIGMA

ASIATIC ACID FROM CENTELLA 10MG

47. AJAX FINECHEM AMMONIUM MOLYBDATE POWDER 500G

48. SIGMA ALDRICH SODIUM PHOSPHATE DIBASIC DIHYDRATE

49. -

GLYCEROL 50% (PREPARED)

50. -

NOAH (PREPARED)

51. R&M MARKETING

GLYCEROL

52. SIGMA ALDRICH

UREA

53. PC LAB REAGENT

IODINE SOLUTION

54. EXPLOSIVE (TOXIC)

-

DMSO

55. SIGMA

TERGITOL SOLUTION 500ML

56. SIGMA PHENYIMETHASULFONYL FLUORIDE 25MG

57. PAA

PENICILIN/STREPTOMYCIN 100ML

58. CLONTECH

COLOMETRIC ASSAY KIT

59. HIGHLY FLAMMABLE

SCHULKE

MIKROZID AF LIQUID 1L

60. -

CLOROX 4L

61. -

DETTOL 2000ML

62. MERCK

GRAM COLOUR

63. SIGMA ALDRICH

N-HEXANE

64. FISHER SCIENTIFIC

ETHANOL (ETHYL ALCOHOL) 96%

65. SIGMA ALDRICH

HEPTANE

66. MERCK

METHANOL FOR ANALYSIS


ACETONITRILE


ACETONE

69. MERCK

ETHANOL

70. MERCK

ACETONITRILE

71. R&M MARKETING

ETHYL ACITATE

72. R&M MARKETING

METHYL RED

73. MERCK

N-HEXANE

74. MERCK

METHANOL

75. MERCK

METHANOL FOR HPLC

76. -

NITRIC ACID (PREPARED)


DIMETHYL SULFOXIDE

78. SIGMA ALDRICH

XYLENE



CHEMICAL

79. MERCK

ETHANOL ABSOLUTE 2.5L

80. -

PARAFORMALDEHYDE

81. - 3’3 DIAMINOBENZIDINE (DAB) LIQUID SUBSTRATE SYSTEM TETRA- HYDROCHLORIDE

82. HAMFUL SCIENCE CELL

FIBROBLAST MEDIUM 500ML

83. R&M MARKETING HAEMATOXYLIN GILL’S NO3 TRIPLE STRENGHT

84. SIGMA ALDRICH

POTASSIUM THIOCYANATE

85. FLUKA

AMMONIUM OXALATE MONOHYDRATE

86. HMBG

POTASSIUM CHLORIDE

87. MERCK

CERTISTAIN

88. MERCK

1-BUTANOL

89. R&M MARKETING

KOVAC’S

90. SIGMA ALDRICH

METHYL RED

91. IRRITANT SIGMA ALDRICH

AMMONIUM HYDROGEN PHOSPHATE

92. SIGMA ALDRICH

CITRIC ACID 99.5%

93. SIGMA ALDRICH CALCIUM CHLORIDE MIN 93.0% GRANULAR, ANHYDROUS

94. SIGMA ALDRICH

CALCON


CHLOROFOME HPLC GRADE

96. SCHARLAU

CHLOROFOME HPLC GRADE

97. R&M MARKETING

CHLOROFOME

98. LAB REAGENT

HYDROCHLORIC ACID 0.1N

99. SIGMA ALDRICH ETHYLENEDIAMINETETRAACETIC ACID DISODIUM SALT DIHYDRATE

100. FLUKA

ACETOXYACETONE

101. SIGMA ALDRICH

ISOPHTHALALDEHYDE 97%

102. MERCK

NATRIUM HYDROGEN PHOSPHATE

103. MERCK

KALIUM DIHYDROGEN PHOSPHATE

104. SIGMA

PHOSPHATE BUFFER SOLUTION (PBS)

105. SIGMA ALDRICH

HEPARIN SODIUM SALT

106. SANTA CRUZ BIOTECHNOLOGY

C-FOS RABBIT POLYCLONAL

107. E.Y LAB UNLABELLED GOAT POLYCLONAL ANTIBODY TO RABBIT IGG

108. SIGMA ALDRICH

TRITON X-100 1000ML

109. SIGMA ALDRICH

TRITON X-100 500ML

110. SIGMA ALDRICH

TRITON X-100 100ML

111. NORGEN

TRITON X-100 100ML

112. SIGMA 3’3DIAMINOBENZIDINE TETRAHYDROCHLORITE (DAB)

113. MERCK

TRIS HCL

114. SIGMA ALDRICH

XYLENE

115. -

CALCIUM CHLORIDE

116. - ETHYLENEDIAMINETETRAACETIC ACID

117. -

ZOLATIL 50



CHEMICAL

118. - DACO LIQUID DAB + SUBSTRATE CHROMOGEN SYSTEM

119.

120. CORROSIVE HMBG

POTASSIUM HYDROXIDE 85%

121. FLUKA

SODIUM HYDROXIDE

122. SIGMA ALDRICH TIN (II) CHLORIDE REAGENT GRADE 98%

123. SIGMA ALDRICH

TRIETHLAMINE HPLC GRADE

124. MERCK

ACETIC ACID (GRACIAL) 100%

125. MERCK

LACTHOPHENOL BLUE SOLUTION

126. SYSTEM

HYDROGEN PEROXIDE 30%

127. PC LAB REAGENT

HYDROCHLORIC ACID

128. FLUKA

CARVACROL

129. MERCK

PARAFORMALDEHYDE 37%

130. R&M CHEMICALS


131. -

PARAFORMALDEHYDE

132. -

SODIUM HYDROXIDE 99%

133. POISONOUS AJAX FINECHEM

DPX NEUTRAL MOUNTING MEDIUM

134. -

PENTOBARBITOL

135. MERCK


136. SANTA CRUZ BIOTECHNOLOGY

C-FOS RABBIT POLYCLONAL

137. E.Y LAB UNLABELLED GOAT POLYCLONAL ANTIBODY TO RABBIT IGG

138. SIGMA ALDRICH

SODIUM AZIDE 25G

139. SIGMA ALDRICH

SODIUM AZIDE 100G

140. - AMMONIUM NIKEL (II) SULFATE HEXAHYDRATE 50G

141. - AMMONIUM NIKEL (II) SULFATE HEXAHYDRATE 500G

142. -

POTASSIUM PHOSPHATE MONOBASIC

143. -

GABAPENTIN

144. -

HEXYL ISOTHIOCYANATE

145. - 3’3 DIAMINOBENZIDINE (DAB) LIQUID SUBSTRATE SYSTEM TETRA- HYDROCHLORIDE

146. -

DACO LSAB 2 SYSTEM - HRP

147. -

PEROXIDE STANDARD PIC- 4000

148. HYGROSCOPIC FLUKA HYDROXYPROPYL METHYL CELLULOSE

149. TOXIC SIGMA ALDRICH GLUTARALDEHYDE SOLUTION GRADE II, 25%

150. NON- HAZARDOUS

SIGMA

SODIUM CHLORIDE

151. SIGMA

SUCROSE 250G

152. SIGMA

SUCROSE 1KG

153. MALAYSIA

SALINE SOLUTION INJECTION TYPE

154. SIGMA PEROXIDE ANTI-OEROXIDE SOLUBE COMPLEX ANTIBODY PRODUCEDIN RABBIT

155. SIGMA

ALBUMIN FROM BOVINE SERUM 10G

156. SIGMA

ALBUMIN FROM BOVINE SERUM 25G



CHEMICAL

157. INVITROGEN

10% NORMAL GOAT SERUM

158. SIGMA


159. -

PHOSPHATE BUFFERED SALINE

160. -

SODIUM CHLORIDE

161. -

DOLETHAL

162. -

KETANIL (KETAMINE)

163. -

ILLIUM XYLAZIL-20

164. -

PHOSPHATE BUFFER SOLUTION 0.1M

165. -

GOAT SERUM

166. HEALTH HAZARDOUS

MERCK


167. SIGMA ALDRICH

XYLENE

168. - PARAFORMALDEHYDE

169. WARNING SIGMA

ANTI RABBIT IGG

170. ENVIRONMENTAL HAZARDOUS

SIGMA ALDRICH

TRITON X-100 1000ML

171. SIGMA ALDRICH

TRITON X-100 500ML

172. SIGMA ALDRICH

TRITON X-100 100ML

173. NORGEN

TRITON X-100 100ML

174. SIGMA ALDRICH

SODIUM AZIDE 25G

175. SIGMA ALDRICH

SODIUM AZIDE 100G

Documents

BORANG TEMPAHAN (RADAS/PERALATAN/BAHAN · PDF fileFAKULTI PERGIGIAN UITM. TEL : 03-61266100 FAX: 03-61266103 * Borang ini PERLU dihantar 3 hari sebelum tarikh penggunaan