CLARKSON UNIVERSITY
TRANSFER, SALE, OR DISPOSAL OF EQUIPMENT
TO:
Risk and Property Management (Box 5563, 2001C Graham Hall)
FROM: Department:_________________________________________________________
DATE:
_________________________________________________________
1. If this instrument contains a sealed source of radioactivity (gas chromatagraph, scintillation
counter, aerosol neutralizer), disposal must be approved by the Radiation Safety Officer.
Approval for disposal:___________________________________________________
Erica Arnold, Radiation Safety Officer
2. The equipment listed below is to be:
Asset #
 1.
Permanently moved from one location to another on campus.
Enter new department, building and room number below.
 2.
Sold for ___________________. Receipt must be attached.
 3.
Destroyed.
 4.
Lost or stolen.
 5.
Title transferred to another University/College.
 6.
Returned to inventory.
 7.
Returned to lender, per loan agreement.
Date:__________ Via __________________
 8.
Other:________________________________
Asset Description
Previous Location
New Location
Dept.
Dept.
Bldg.
Room
Bldg.
Room
DEPARTMENT HEAD APPROVAL ______________________________________________________