Click here for the Disposal of Hazardous Waste Form.
The Requester is the person who is responsible for the generation of the waste(s). The Requester must provide the following information:
Their name (printed);
Their department/affiliation;
The date of the request;
The building location where the waste is generated;
The room or lab number where the waste is presently stored; and
A telephone number where the Requester can be contacted.
The Requester must complete each part of the waste identification section. If additional pages are required, the requester must indicate the total number of pages included in the request.
Name of Chemical(s) - the correct chemical name or names shall be written on the request form and all container labels. Chemical formulas and trade names are not acceptable. Example - Methylene Chloride, not CH2 Cl2. If available, include the Chemical Abstracts Service (CAS) registry number. example - Methylene Chloride CAS No. 75-09-2.
For mixtures of liquids, all constituents must be listed on the request form and the container labels. The total percentage of constituent must equal 100%. Solutions of solids or gases in liquids must be expressed in concentrations of either weight percent, molarity (moles per liter), or normality (equivalents/liter).
Identify the total quantity of the waste material and include the unit of measure (UOM) such as grams, ml, liter, gallon, pound, etc.
List each hazard code known for the waste materials. For waste mixtures, list the primary (most significant) hazard codes.
Any request form that is incomplete will be returned to the Requester with any deficiencies identified.
All containers must be properly labeled with the words
"Hazardous Waste". Identify the chemical name
or names. Containers that
are not properly labeled will not be pickup.