Hazardous Waste Pickup Request Form

 

As a service to the campus community, Environmental Health and Safety provides a hazardous waste pickup service. Please fill out the form below with as much detail as possible and we will contact you to setup a time for one of our employees to come and pick up the chemicals.

We do not provide this service to the general public or any corporation. If you are not a department of the University, we recommend you contact a company listed under Environmental Services in the yellow pages of your phone directory.

If this is an emergency, do not fill out this form. Instead call 911.

 

Contact Person:
Contact Phone Number:
E-Mail Address:
Storage Area: Building/Room
Special Notes: (optional)
# Container Type Container Size Units Percent Full Contents
Example: Carboy 5 Gallons 10%-19% 60% Water; 40% Potassium carbonate
1
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10