Waste Pickup Request

To let Environmental Health, Safety and Risk Management know that you are in need of a waste pickup, complete the following and then click on the Submit button.

All fields marked with an asterisk (*) are required.

text field

Department:

text field

Name:

text field

Phone Number:

required email address field

Email:*

text field

Building:

text field

Room/Lab Number:

text field

Day/Times Available for Pick-up:

textarea field

Waste Description:

Include a brief description of the waste, such as form, quantity, chemical hazards present, etc.

radio button field

Supplies Needed?

Yes

checkbox field

If you answered yes above, check the appropriate box(es) to indicate the supplies needed.

Carboy

30 Gallon Drum

Labels

Sharps Container

Link (required)