Air Products and Chemicals, Inc.

CPS Information Request

In order for Air Products to better understand your plant support needs, please complete the following form.

*Denotes Required Fields
*Name:**
*Title:**
*Company:**
*Address 1:**
Address 2:
Address 3:
*City:**
Province/State: (2 letter abbreviation required for US)
*Country:**
*Phone:**
*Email:**

Do you use industrial gases at your facility (i.e., oxygen, nitrogen, argon) Yes No Not sure

If yes, how is the product delivered? You receive the gas via a pipeline (i.e., you only purchase the gas) Your company owns an air plant that makes oxygen, nitrogen, and/or argon for your facility Cylinder (small quantity) Product is delivered to an onsite storage tank and vaporized at your site Not sure Other (please specify)