Rodent Anesthesia Machine Rental Request

Please submit rental requests at least 2 business days before the date needed.

ULAR has a limited number of rodent anesthesia machines. Availability depends on demand.
Requests are processed in order of receipt.

If you need training on use of the equipment, contact ULAR Vet Services (949-824-5079).

The recharge rate is $50 per half day (half a day is the minimum).

Labs are responsible for the equipment from the time that ULAR delivers the equipment to the
time that ULAR picks up the equipment (which may be the next business day if the rental
period extends after 3:30 pm). Labs will be recharged for any missing or damaged equipment.

Complete the Information section and fax the entire page to (949) 824-2003.
INFORMATION:
Date:
Account:
Fund:
Sub:
Principal Investigator:
Department:
Contact Person:
Phone #:
Email:
Rental Start Date:
Rental Start Time:
Rental End Date:
Rental End Time:
Location:
For ULAR Use:
Item
Out
In
Item
Anesthetic Machine
O2 (enter # of E tanks)
Vaporizer
Tubing
Delivery System (mouse)
Induction Chamber
Delivery System (rat)
Directions
Cart
F/Air canisters (2)
Duration of Rental:
Amount for rental ($):
Submitted for billing
(intial):
Amount for lost or damaged
equipment ($):
Out
In
TOTAL RECHARGE ($):
9/6/13