Waste Disposal Request Form

Type of Waste Disposal Pick Up:*

Chemical

Biological

Hazardous Materials

Specimen(s)

Please select the type of waste disposal pick up you are requesting.

Building:*

Please provide the name of the building where the material is located.

Room Number*

PI/Researcher Name:*

Please provide the name of the PI or researcher responsible for this lab.

Location of Waste:*

Fume Hood

SAA

Designated Cabinet

Other

Please provide the chemical and/or waste name and quantity (volume, etc.) for each waste item. Specify type of container and ensure all containers are properly labeled with the EHS Hazardous Waste Label. List, in detail, the contents of all red biohazard bags and Sharps Containers.*

Total Number of Waste Containers:*

Full Name of Requesting Personnel:*

First Last

Email of Requesting Personnel:*

Enter Email Confirm Email

Phone Number of Requesting Personnel:*

Are any of these waste items reactive?*

Water-reactive

Air Sensitive

Shock Sensitive

Temperature Sensitive

Explosive

None

Does your laboratory currently have a Satellite Accumulation Area (SAA)?*

Yes

Comments

This field is for validation purposes and should be left unchanged.

Waste Disposal Request

Process Time

All waste disposal requests are retrieved, weather permitting, in the order they were received. Inclement weather, primarily rain, will delay all waste pick-ups. Please be mindful.