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Chemical Waste Collection Request Form
To request chemical waste collection online, complete this form.  Alternatively, a PDF (print) version of this document is also available and may be completed and faxed to 3-7036.

  Complete this Contact Info section
Date
Contact Name
Contact Phone
Contact Email
(A summary of your request will be sent to this email address.)
PI Name
Building
Room
Department
 
Complete this section for Chemical Waste
 
Chemical Name and percentage
(example:  Methanol-70%, Water-30%)		 Number of
Containers		 Size of Containers
  Additional Comments
 
 
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