Hazardous Waste Pickup Request : Environmental, Health, Safety, Risk and Emergency Management : Texas State University

Department *

Name *

Email *

Phone Number *

Building *

Room/Lab # *

Waste Description *

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

Please upload a picture of the waste.

Containers ready for pick up

Carboy

Drum

Chemically Contaminated Sharps

(black or green box)

Chemicals in Original Container

(expired chemicals)

Empty Container Previously Holding a P-Listed Substance

Other

If other was selected in the above question, please describe.

If requesting pickup for a container that previously held a P-Listed substance, please provide the chemical name.

Are you in need of any additional supplies? *

Includes carboys, 30-gallon drums, labels, broken glass box, sharps container, etc.

Yes

No

What EHSREM supplies are needed? *

You can select more than one.

Carboy

30-Gallon Drum

Labels

Broken Glass Box

Sharps Container

5 Gallon Bucket for Solid Waste

Is the waste container label completed with the container contents? *

Yes

No

Comments

If you feel EHSREM needs additional information, please include it here