Environmental Health & Safety
Chemical Safety Waste Pick-up Form
Please reference the Used Chemical Collection Fact Sheet for information on chemical collection pick-ups...
Click here if you need chemical tags sent to you...
E-mail Address (required to begin)
Your E-Mail Address
Your e-mail address will allow you to complete your task over several sittings, if necessary. Entries are saved as you type. If you browse away from a partially-completed form and return to an empty form, enter your e-mail address and press "Tab".
("Finished" work is not available to restore.)
Your First Name
Your Last Name
Enter Your Chemical Waste Items
(To enter more than one chemical, press "Add Another Chemical Tag".)
Chemical Collection Tag #
Chemical Name(s) / Percent (must equal 100%)
Type the text from the image into the space below.
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