Indiana University Indianapolis Indiana University Indianapolis IU Indianapolis

Environmental Health & Safety


Waste Pick-Up Request Form

 

Max characters are 255 for all fields, except for the Questions/Comments field.

Department: Building:
Contact Person : Phone:
Location of Material: Pager:
Room:    
Email:    
Organization:    
Description  ( 125 Characters Max ) - Chemical Name Number of Container Size Unit (select one) Total Amount
         
Questions/Comments:

By clicking submit, I attest that I have inspected each container in the manifest and have disclosed the presence of any damaged or compromised containers.