EO Processing Order Form

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EO Processing Order Formjpite2022-08-01T18:02:56-06:00

For Questions or More Information:
Phone: 303.531.1238
Email: luke.duncan@boulderiq.com

EO Processing Order Form

Name

First Last

Email

Username

Company

Phone

Address

City

State/Province

Zip/

Country

Shipping Information

Return Shipping Method

Fed Ex

UPS

Pick-up

Return Shipping Service

Overnight

Two-day

Ground

Account Number

Ship To

Address Above

Different Address

Different Shipping Address

Service Requested

Service Level

Base

Expedited (add'l fees)

Return By

MM slash DD slash YYYY

Cycle Temperature (°C)

Preheat Time (minutes)

Vacuum (mbars-maximum)

Relative Humidity (%)

EO Dwell Time (minutes)

Aeration (hours-minimum)

Concentration (mg/L)

Special Instructions:

Product Information

Product Name

Part Number

Revision

Quantity

Lot Number

Intended Use

Production (Validated cycle, load configuration, and sterilizer, BIs required)

Non-Production (R&D/Engineering cycles, BIs by request)

Protocol/Validation (Batch release or Validation Projects)

2X Sterilization (Product sterilized twice)

No Testing Required

Testing

BIs/PCDs

Sample Quantity & ID

LAL

Sample Quantity & ID

Bioburden

Sample Quantity & ID

Bioburden Extraction Efficiency

Sample Quantity & ID

EO Residuals

Sample Quantity & ID

Other

Sample Quantity & ID

The Client acknowledges and agrees that it is solely and exclusively responsible for (i) ensuring that the process and specifications are appropriate for the Products, (ii) the validation of the EO cycle, (iii) product sterility, (iv) the integrity of the product packaging, (v) the adequacy of product labeling and (vi) compliance with any and all FDA or other regulatory requirements.

Yes, I agree to the Disclaimer

Authorized Representative

Title

Date

MM slash DD slash YYYY

Upload Your Purchase Order

Max. file size: 50 MB.

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Boulder, CO

info@boulderiq.com
(303) 531-1238

5421 Western Ave
Boulder, Colorado
80301

Contact Us

5421 Western Ave
Boulder, CO 80301

Phone: 303-531-1238

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