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Hazardous Material Pickup Request

Allow 3 - 5 days for pickup, then call or send email if you're concerned.  
Complete ALL Requested Information.

Principal Investigator Name:
Principal Investigator Phone:
Requested by:
Your Email Address:
Your Campus Phone:
Building and Room:
Department Name:
Department Code (4 Digits):

Enter up to 10 chemical descriptions. It is imperative that you enter chemical descriptions that are acceptable to REM, and that the descriptions you give here are IDENTICAL to the descriptions on the container labels. Note that if you have identical containers you may enter them on a single row. Use column heading links to see useful hints and information.

Item ID
(Not
Required)		 Chemical Description
MUST MATCH CONTAINER LABEL		 Number of
Containers		 Container
Size		 Amount
in
Container		 Spent
or
Useable		 State
S, L, G

Enter special instructions or comments (e.g. "If room is locked - get key from Sherry in 314."):

 

 

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Last Modified: Wednesday, July 9, 2008
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