Environmental Health & Safety
Chemical Safety Waste Pick-up Form
Please reference the Chemical Disposal 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 pick-up, press "Add Another Chemical Tag".)
NOTE* If you have multiple containers of the same chemical constituents or are cleaning out a laboratory area, please contact EHS at 9-4386 for specific instructions prior to filling out form or collection tag.
Chemical Collection Tag #
Chemical Name(s) / Percent (must equal 100%)
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