Universal Waste Pickup Request • CampusOptics

Skip the "Accumulation Started Date" and "Percentage" fields.

There is no need to print the container labels shown on the next page.

Requester Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Location

Name* Required

Additional Location Details

Order Supplies

To request additional supplies, complete the form at the link below.

Request Supplies

Container 1

Container Type* Required

Container Contents

Type

Percentage

Please check each box to certify each statement* Required

Containers are labeled correctly

Container is compatible with the waste type

Exterior of the container is clean and in good condition

Container is properly closed (no funnels, cannot spill, no pouring devices)

The waste is not radioactive

All materials are identified (no unknowns)

I hearby declare that the identification/description of each waste is accurate and complete, and that I have made a reasonable effort to minimize this waste. Please insert your name to certify this statement.* Required

Would you like to be present when the waste is picked up?* Required

Department

Requester Info

Location

Order Supplies

Container 1

Container 0