Chemical Waste Pick-up Form

Date: 10/17/2021

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".)

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.


Type the text from the image into the space below.

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