Lanxess Business

First name:

Last name:

E-mail Address:

Phone Number:

Company name:

Country:

State:

City:

Region:

Cylinder Type * :
Please Select ALKYLTAINER 9.0 ALKYLTAINER 8.1 ALKYLTAINER 8.0 ALKYLTAINER 7.0 ALKYLTAINER 6.1 ALKYLTAINER 6.0 ALKYLTAINER 5.1 ALKYLTAINER 5.0 ALKYLTAINER 4.1 ALKYLTAINER 4.0 Others

Cylinder Serial * :

Number of Cylinders * :

The valves are tight and sealed with blindflanges *:
Yes No

The cylinder(s) in good physical condition *:
Yes No

The IMO-labeling on the cylinder(s) is still the original that has been sent and has not been modified *:
Yes No

The cylinder(s) is/are empty and uncleaned *:
Yes No

For Uncleaned Cylinders:

The cylinder(s) filled with LANXESS material; No other product has been filled into the container.
Yes No

Net/Gross Weight:

Net/Gross Weight: (net equals gross in case of empty tainer) If multiple cylinders are being returned please provide weight details in the comments field

KG
Net Gross

Dangerous goods details in accordance to IMDG regulations

Proper shipping name:

UN Number:

IMO-Class:

Package-Group:

Customer Comments: