Sample Analysis Service with Bioanalyzer In: Out: Functional Genomics Laboratory, 255 Life Sciences Addition MC-3200, Berkeley, CA 94720-3200 Please contact [email protected], Tel: (510) 642-1165, or Fax: (510) 642-1219 Date___/ ___/____ User Information *UC Funding Code/PO#: Fund Manager Information Name Email TEL Name Email Dept./Inst. P.I. TEL Possible biohazard Yes** / No Sample name Nucleic Acid total [ ] Prokaryotic 4 [ ] Eukaryotic 5 [ ] mRNA 6 [ ] small RNA 7 RNA pico (>3.0ul) DNA-1~50ng/ul DNA HS-0.05~3ng/ul 2 DNA FGL’s Volume RNA-0.5~5ng/ul 1 Human/Mouse/Rat or _____________ Used method to estimate concentration________________ Origin RNA Info about Chip User’s [ ] DNA [ ] Other_________ samples Info about your [ ] RNA Conc.*** 3 RNA [ ] 1000 8 [ ] 7500 / 12000 9 [ ] High sensitivity 0 Notes: 1 Used Date DNA HS ($10) x___= RNA pico ($8) x RNA DNA DNA 1K or 12k($7)x___= ___= Small RNA ($9)x ___= *Please note that we will not process without this info. ** Please contact FGL before submitting your samples if your samples are potentially bio-hazard. ***Please note that Nanodrop tends to overestimate low concentration samples (<100ng). Please note that RNA & DNA-HS chips hold only 11 samples/chip but DNA chips (1000 or 12K) holds 12 For Office Use Only~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Send request to: Functional Genomics Laboratory/QB3 Recharge account - Attention: Y. Justin Choi UC Berkeley 255 LSA MC-3200 Berkeley, CA 94720 On-campus rate: __________ Off-Campus Rate: Affiliate x 7.53% =__________ Non-UC x 1.70% =_________ Total: __________ Financial Journal #____________date______ BIOANL . Sample ID # User *Conc. [ng/ul] of ds-cDNA FGL Volume (>3.0ul) Other info.