Online Form - Chem Waste Pickup

Chem Waste Pickup

Asterisks (*) indicate required fields

This form should be completed to request pickup of Chemical Waste. In most cases, chemicals submitted online will be collected within 2 working days.

Complete all Waste Generator Information fields.
Click the Submit button to submit.
LABELS: Click here to print a Spent Chemical Label. This label can serve as the container label, and should be printed and attached to the container prior to pick-up. After submitting the form, you can print a receipt of this request.

Date *

Waste Generator Information:

Requestor Name *

Email *

Phone *

Building*

Room *

Other Room

Principal Investigator *

Waste Location *

Inputting Chemical Information for Pickup:

Please select the chemical name from the list of chemicals in the dropdown menu. If the chemical does not appear on the list, please select Chemical Not Found and type in the correct chemical in the description section.

All waste to be picked up must have a green sticker affixed to container(s)
(Failure to label with a green sticker may cause a delay in your pickup request)

Special Non-chemical Pickups?

Carcass click here Batteries click here Fluorescent Light Bulbs click here

Chemical Name *

Lookup

Description

Bulk Pickup (5 items or more)

Container Type *

Number of Containers *

Weight / Volume

Units

Physical State *

Replacement Container Needed *

Yes

Equipment

Other (Enter details in additional information box)

Additional Information

Please specify any additional information that would be critical to the safe and secure pickup of your waste. If you have any specific needs or time restraints, please specify these as well and we will do our best to accommodate them

Resources:

Download Adobe Acrobat Reader Adobe Reader

Download Word viewer, or download Excel viewer, or download PowerPoint viewer Microsoft Viewers