EXPORT TEAM USE

Sika R&D Sample ONLY

Transport Request Form SAP ORDER NUMBER:

ALL FIELDS MUST BE COMPLETED BEFORE SUBMITTING - 5 WORKING DAYS NOTICE IS REQUIRED

Date 17/01/2023
Requested By (full name) Mr Nathan Peeler
Delivery Company Name ParexGroup SAS
Delivery Address PAREXGROUP SA
- must include Zip Code 105 rue de Santoyon
- PO Box numbers not allowed Parc d’activités de Chesnes Nord
38070 Saint Quentin Fallavier
France
Delivery Contact Name Guillaume Le Saint
Delivery Contact Telephone Phone: +33 4 74 99 13 27 · Mobile: +33 6 84 15 31 87
Delivery Contact Email lesaint.guillaume@fr.sika.com
Is the sample FOC? (YES/NO) Yes
Company Contact
Who is paying freight? Sika Limited Nathan Peeler
Name Name
Dimensions Weight
Packaging Type (pallet/box) Box 37 x 49 x 742 30.407
(cm - LxWxH) (kg)
Location of goods in warehouse Site A (Goods in)
GGBS GGBS Saica Fly Saica Sleaford
Product Name Minfil L75 Snowcal 80 Calofort S Calofort U Slate dust
Hanson Ecocem Ash Bottom Ash Fly Ash
Quantity (number) 1 bag 1 bag 1 bag 1 bag 1 bag 1 bag 1 bag 1 bag 1 bag 1 bag
Unit Size (kg) 3 3 3 3 3 3 4 3 2 3

Batch Number (R&D use only)

Colour Reference (R&D use
Pale yellow Pale yellow White White White White Grey Grey Grey Grey
only)
Article/SGAN Code
441259 449023 N/A N/A N/A 650353 N/A N/A N/A N/A
(N/A = ONLY if not yet created)

Sika R&D Sample Transport Request Form

 Tariff/Commodity Code
6802100000 6802100000 6802100000 6802100000 2618000000 2618000000 6802100000 2621100000 2621100000 26211000
(ALWAYS required)
Is it a non-stock item? (YES/NO) No No Yes Yes Yes No Yes Yes Yes Yes
Value of Goods for Customs
(average sample = £2.50 per 0.5 £5 £5 £5 £5 £5 £5 £5 £5 £5 £5
kg)
Is the sample hazardous?
No No No No No No No No No No
(YES/NO)
UN Number
(found on MSDS)
If YES, Class
please (found on MSDS)
complete Packing Group
these (found on MSDS)
codes UN Packaging Code
(found on
packaging)
PLEASE EMAIL THIS
EXPORT export@uk.sika.com UK ashcroft.leanne@uk.sika.com
COMPLETED FORM TO:

Sika R&D Sample Transport Request Form