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Click HERE for Form Instructions in a separate window. Click HERE for Waste Classification Chart in separate window.
Click HERE for MSDS web site in a separate window

Click HERE for Waste Determination Flow Chart in separate window  

Hazardous Waste Pickup Form

Please fill out the following form as completely as possible.

Location Information
Department:
Building:
Room Number:


Principle Investigator Information
Principle Investigator:
Pickup Coordinator:
E-mail Address:
Phone Number:


Chemical Information
Item:

Chemical or list of Constituents in %
(No Trade Names Please):

Container Size:
(Indicate Units)
Number of Containers:
UCF
Barcode
Waste Classification:
# 1
# 2
# 3
# 4
# 5
# 6
# 7
# 8
I need SMALL Waste Labels

I need LARGE Waste Labels

 Comments:
 
* Required: Please type your initials in the box below.  By doing so you are certifying that the waste has been properly labeled and is packaged in appropriate containers which are sealed and compatible with the chemical(s) it contains.
 


We will make every attempt to pick-up the waste within 7 business days of receiving this form.  Please note: EHS cannot transport highly reactive wastes.  These wastes should remain in a safe area of your lab until a licensed waste disposal contractor can be scheduled. If you have any questions,  please call the Environmental Health and Safety Department at 3-0474 or email us.

Leave the containers with the hazardous waste labels visible in a designated Satellite Accumulation Area (SAA) or in a visible place in the room noted on the request form.  Thanks.