Environmental Health, Safety & Risk Management
Successful Solutions Start with Safety

Chemical Waste Pickup Request

Name:


Phone:


Building:


Room/Lab:


Please refer to chemicals only by their full name.
Chemical Contents: (one chemical per line please)  Concentration/Volume:

1. Have the chemical(s) been neutralized?
Yes
No

2. What Specific Hazard(s) are represented by the chemical(s)?
Flammable
Corrosive
Reactive
Toxic

Additional Comments:


Site last updated: September 16, 2009