Request for HR-MS Sample Analysis UCSD Chemistry & Biochemistry Mass Spectrometry Facility NAME: SUBMISSION DATE: PHONE: E-MAIL ADDRESS: 5-digit/letter SAMPLE ID CODE SOLUBILITY: (check all that apply) ----CH3OH ----THF ----Isopropanol ----Acetone ----Other: NAME OF PI: ADVISOR PHONE: INDEX NO.: PROPOSED STRUCTURE & FORMULA, AND EXACT MASS: (molecular structure is ESSENTIAL, hand-drawing or cut-and-paste from ChemDraw) ---- CH3CN ---- n-Propanol ---- CH2Cl2 TYPE OF SAMPLE Predissolved samples are preferred. Refer to MS facility website for sample preparation guides: ( http://chem-tech.ucsd.edu/Recharges/MassSpec/) -----NEAT SOLID ----NEAT LIQUID CONFIDENCE: ----Confident ----Confirmed by ___________ PURITY: -----Fairly pure -----Very Pure SOLUTION: Dissolved in _____________ at ____mg/ml PROPOSED FORMULA: SPECIAL HANDLING: (check all that apply) ----Acid Sensitive ----Light Sensitive ----Heat Sensitive ----Air Sensitive EXPECTED EXACT MASS: ----Moisture Sensitive ----Toxic ----Biohazards ----Radioisotopes ----OTHER (describe): ADDITIONAL INFORMATION: (any information that is helpful) ANALYST’S COMMENTS: (will be filled by MS operator) -----ESI -----EI -----CI -----FAB (Matrix: ------M -----M+H -----M-H -----M+Na Theoretical Mass: ANALYST: Reference: -----Other: Measured Mass: RUN-NAMES: ) Error: ANALYSIS DATE: Formula: HOURS: CHARGES: $_______________ Please acknowledge the UCSD Chemistry and Biochemistry Mass Spectrometry Facility in your publications.