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Waste Pickup Request Form

Waste Pick-Up Request

AU Name:
Bldg/Room Number:
Contact Name:
Phone:
Waste Pickup
Solids: Scintillation vials:
Liquids: Pathological:
Supplies Needed
Pails:
Carboys: 0.5 l : 1 l : 2 l : 2.5 gal :

Chemical Mixed Waste:  Yes    No    Unsure (describe in comment box)

Biohazard:  Yes    No    Unsure (describe in comment box)

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