Chemical Waste Pick-up Form

Date: 03/28/2023

E-mail Address (required to begin)

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.)

My Information

Enter Your Chemical Waste Items (To enter more than one chemical pick-up, press "Add Another Chemical Tag".)


Type the text from the image into the space below.

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