SURPLUS REQUEST FORM Request ID: Request Date: // Request Status: Pending C&G Review Department: College of Sciences - Dean Pick Up Location: A Comments: Room is unlocked Most items in Hallway as you head toward Contact: Phone: Email: Surplus Action: Terry Byron /- tbyron@ncsuedu Pick-Up QTY Lot N Description Apple - Mac Mini Serial# CGXGHDKDJ Project Asset Tag# N Apple - Mac Mini CJXCPDYH Good N Apple - Mac Mini CGKHCDJD Good N Laptop - Apple CWJGWN Good N Apple - Mac Mini CHHRDKDJ Good N Laptop - Apple CWRWUGWL Good N Laptop - Apple CWRWGWL Good N Netgear Port Switch NA Asset ID Condition Good Good QTY Lot N Description Apple - iMac Serial# DWQTZJGN Project Asset Tag# Asset ID Condition Good N Apple - iMac DWQCJGN Good N Apple - iMac DMRZFJC Good N Apple - iMac DPKQFY Good N Bean Bag Good N Apple - Mac Mini CGXDJD Poor N Laptop - Dell Lat DDP Poor N Laptop - Dell XPS CTW Poor N Apple - Mac Pro (Trashcan) FKRVUF Poor N PC - Dell All-in-One FWRP Poor N Apple - Mac Pro UPZ Poor N Apple- Mac Pro GRDH Poor QTY Lot N Description Apple - Mac Pro Serial# GRAH N APPLE PRO MAC HEUG N Apple - Mac Pro GUPZ Project Asset Tag# Asset ID Condition Poor Poor Poor Certifications Hazardous Materials Notice Y Certified By TBYRON // : PM Person/Department disposing of equipment that (i) may have been used to process hazardous materials, or (ii) may contain hazardous material which cannot be removed, or (iii) which contains radioactive materials, must receive clearance as appropriate from the Environmental Health & Safety Dept, or the Radiation Protection Office before this equipment may be surplused Data Security Note Y Certified By TBYRON // : PM When including devices that may have internal storage (eg, copiers, printers, scanners, projectors, etc) on this form, please check with the manufacturer for verification if storage exists If equipped with internal storage, it is the responsibility of the department to erase all data on the internal storage or remove it before turning the device over to Surplus Devices with internal storage retain images made during the life of the equipment Risk Management Y Certified By TBYRON // : PM Person/Department disposing of (i) tractors, mowers, skid steers or (ii) cars, trucks, vans and trailers, must provide signed copy of the surplus request with signatures from your department and Surplus Property to remove the item (s) from Risk Management Insurance Created By: TBYRON // : AM Last Updated: TBYRON // : PM