Request for Collection of Waste Chemicals

Request for Collection of Waste Chemicals
Faculty or Principle Investigator for Laboratory: *
Today's Date *

Month Day Year
Date
Pick up Contact: *
E-mail of Contact: *
Telephone:
Building: *
Department/Office/Division *
Lab (Room #): *
Location of waste within the room: *
Instructions:

1. Refer to EPA hazardous waste table in the MTU hazardous waste disposal procedures or contact wastepickup-l@mtu.edu

2. If not on the hazardous waste table use "non-RCRA" as the EPA waste ID no.

3. Enter each container as a separate line item below
Please supply an index to be charged if the chemical to be disposed of is for any one of these reasons:
- From a teaching laboratory
- From a spill cleanup
- Not from a lab
- An "unknown" waste
- Leftover chemical(s) from previous research
- Other
Enter index to be charged here (only if it meets the criteria listed above)
Should be Empty: