Please email questions to HazWasteRequest.

Name:

Date:

Phone:

Room/Lab#:

Building (McD, AH, IBT, STCBM, Med, Dent, etc.):
 
1. Is request for chemical, fixer, or both?
Chemicals
Film Fixer

2. If fixer, how many fixer exchange containers do you need?
Containers

3. Do you need pickup tags? (Note: Tags are now required for waste pickup.)
Yes
No

4. Number of containers for pickup:

	Solid
	Liquid
	Gas

 
Comments: