&
deptlogo

Chemical Waste Pickup Request Form

Instructions

Columbia University Environmental Health and Radiation Safety / Environmental Health and Safety (EH&RS/EH&S)
S.W.Mudd Building, Suite 350 Telephone #: 212)854-8749 Fax #: 212)316-4937
If you need chemical waste pickup, please fill out this form and press the submit button at the bottom of   the page. Label all containers using the RED hazardous waste labels. If you have any questions please call  212)854-8749.

General Information

Date (mm/dd/yyyy): Requested By:

Responsible Investigator:

Building/Room Number:

Telephone Number:



Items

Item 1:   Solid      Liquid     Gas

Chemical:

Quantity:

Location:



Item 2:   Solid      Liquid     Gas

Chemical:

Quantity:

Location:



Item 3:   Solid      Liquid     Gas

Chemical:

Quantity:

Location:



Item 4:   Solid      Liquid     Gas

Chemical:

Quantity:

Location:



Item 5:   Solid      Liquid     Gas

Chemical:

Quantity:

Location:



Remarks



Go to Top
Go to EH&RS Home Page