FORM - Fermentation - New Application Form Agri-Food Discovery Place Entry Application [Fermentation]

Fermentation - New Application Form Agri-Food Discovery Place Entry Application [Fermentation]
Entry Application for Research and Development at the University of Alberta's Agri-Food Discovery Place.
Client Information
Name
First Last
Company name or Speedcode (UofA only)
Department
Phone
Email
Legal / Billing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Is your Shipping Address different than your Legal / Billing address?
- Yes
- No

Save and Continue Later

Fermentation Project Description
Project Name
Describe the project:
What is the size(s) of fermentation bio reactor (Select all that apply, or Other below)?
- 5L
- 140L
- 2000L
Other size?
Provide detail.
Describe the microorganism to be used.
Include all characterization and background of the strain(s).
What analytical requirements are needed?
e.g. pH, DO, Glucose, etc.
Describe the media.
List all ingredients to be used.
Down stream processing equipment requirements:
- Filtration
- Homogenizing
- Centrifugation
- Membrane filtration
Other down stream processing equipment requirements?
Provide detail.
Preferred start date
Date Format: MM slash DD slash YYYY
Expected end date
Date Format: MM slash DD slash YYYY
Expected hazards related to the fermentation

Save and Continue Later

Finish
Number of applicant staff requiring access to AFDP
Names of applicants staff requiring access to AFDP
Please separate names with commas.
Will you be working outside normal AFDP hours 8:00am to 4:00pm
- Yes
- No
Occupational Health and Safety
All clients who will be working in AFDP are required to complete health and safety orientation and training prior to commencement of the project. Required training includes WHMIS, Laboratory Safety, Chemical Safety and/or Concepts in Biosafety, provided by the University of Alberta. Additional job specific training may be required.
Agreement and Signature
The Freedom of Information and Protection Act authorized the collection of personal information on this application as it will be used to contact the applicant in matters relating to application. If you have any questions about the collection or use of this information, contact Bob Rimes, Executive Director of AFDP, 780-492-6945.
By entering your name and date below, you state that the information you have entered on this form is correct.
Name (First and last)
Date
Date Format: MM slash DD slash YYYY
CAPTCHA

Save and Continue Later

Fermentation - New Application Form Agri-Food Discovery Place Entry Application [Fermentation]