Waste Disposal Request Form

Waste Disposal Request

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Type of Waste Disposal Pick Up Please select the type of waste disposal pick up you are requesting *

• Chemical
• Biological
• Hazardous Materials
• Specimen(s)

Building where this material is located? *

Room Number *

Please provide the name of the P.I. or researcher responsible for this lab. *

Multiple Choice *

• Fume Hood
• SAA
• Designated cabinet
• Other

If other, please provide a description below:

Please provide the chemical and/or waste name and quantity (volume, etc) for each waste item. Ensure all containers are properly labeled with the EHS Hazardous Waste Label. *

Total number of waste containers. *123456789101112131415+

Full name of requesting personnel *

Email of requesting personnel *

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
• No

Submit

Process Time

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