Intent to Ship Dry Ice
After reading the UA Guide to Shipping with Dry Ice, fill out this form to qualify to ship dry ice. EHS will review the completed form with you and, upon successful completion, will certify you to ship dry ice. This certification will expire after two years.
1. Why is dry ice considered a hazardous material?
2. Which of the following labels/markings MUST appear of a package containing dry ice? Circle all the apply:
Class 9 hazard label Class 8 hazard label
Net weight of dry ice Dry ice, UN 1845
Biohazard symbol Diagnostic specimens
Inner packages comply with prescribed specifications
3. It is okay to ship dry ice in any plastic cooler. T F
4. I have to put a class 9 label on the box only when there are other dangerous goods in the box. T F
5. It is acceptable to put a class 9 label on the top or the bottom of the box. T F
6. The only consideration when re-using a dry ice shipping box is labeling it with the correct address. T F
7. If you are shipping non-hazardous plant tissue samples to a lab for diagnostic analysis, it is okay to write on the shipping box, "Diagnostic specimens enclosed". T F
Print Name:
Signature:
Department:
Date: Phone:
Please return in campus mail to EHS, 15 Research Drive.