Custom Packed/Micropacked Column Request Form

Column Parameters

RFQ Number

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Number of columns

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Column Length (including voids)

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Unit

Tubing

Packing Description

Enter up to three liquid phases. Remember to specify the coating percentage for each one.

Coatings >15% may incur additional charges.

liquid phase A

liquid phase B

liquid phase C

Solid Support

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Mesh

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Information on mesh size–micron conversions:

If you do not know your mesh, enter "unknown" and Restek will make a recommendation.

Configuration (One),

Standard Configurations: click the diagram to select

General Configuration

Agilent 5880, 5890, 5987, 6890, 7890, 8890

Varian 3700, Vista Series, FID, Bruker 430

PE 900-3920, Sigma 1,2,3

PE Auto System 8300, 8400, 8700 (not on-column)

For Instrument Types Not Listed Above:

Special Configurations: click the diagram to select

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Contact Information

Restek Account #

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First Name

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Last Name

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Phone Number

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Company Name

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Address 1

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Address 2

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City

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Country

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State/Province

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Postal Code

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Custom packed columns are not returnable or refundable. I understand and agree to these terms.

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