Please enter all information requested below and click on the "submit" button to complete request.
Please provide the following contact information:
Name Title Work Phone FAX E-mail
What is the building number where the waste is located?
What is the room number where the waste is located?
What type of container is the waste in? (select any of the following options that apply):
Glass Plastic Carboy Safety Can 40 gal. Drum 55 gal. Drum
What category of waste do you have? (select any of the following options that apply):
Halogenated Solvents Non-halogenated Solvents Organic Acids Inorganic Acids Organic Bases Inorganic Bases Heavy Metal Reactives
How much waste do you have? Choose one of the following options:
Less than 1L Between 1L and 4L Greater than 4L
Have you filled out a hazardous waste tag for the items to be picked up?
Yes No Proper tags are tan in color and have SH0 FORM 15-13 in the lower right hand corner. Please call ext.4055 if you need the new tags. (NOTE: Forms must be filled out completely for your waste to be picked up. The common chemical name on the MSDS sheet for the chemical must be used - not the formula. Provide feedback on this form (click here)
Yes No
Proper tags are tan in color and have SH0 FORM 15-13 in the lower right hand corner. Please call ext.4055 if you need the new tags.
(NOTE: Forms must be filled out completely for your waste to be picked up. The common chemical name on the MSDS sheet for the chemical must be used - not the formula.
Provide feedback on this form (click here)