Laboratory/Chemical Waste Disposal Form

Please contact cmc@ysu.edu with any questions regarding laboratory waste.

Department Requesting Waste Disposal

Location of Waste (Building & room number)

Responsible Faculty Name

Your Email Address

Number of Containers and container size/type (e.g., "three 1L glass bottles", "2x1 gal. plastic jugs")

ALL containers must have lids. Liquids may NOT be stored in open-head/'open-top' drums or pails/buckets.

Do all waste containers have a completed label?

Yes

ALL waste containers MUST have a COMPLETED label PRIOR to removal from the lab. Visit ysu.edu/ehs/cmc/waste/hazardous/guidelines for labeling instructions & to obtain waste container labels.

Container may NOT be picked up or removed from the lab until properly labeled

Brief Description of Your Waste (Waste name/type, or process/activity, project/experiment)

Provide a brief description of the waste generated: e.g., 'Used cutting fluid & water', 'Halogenated spent organic solvent waste', 'corrosive inorganic acid solutions', etc.

Chemical Component Names & Quantities (specify each component name & estimated amount in % wt. or vol.)

Approx. % Vol. or Qty, with units (in mass/vol.), of each chemical component in the waste. e.g., 'Silver Stain Waste': methanol (<=20%), Phosphoric acid (<=5%), glacial acetic acid (<=5%), silver nitrate (<1%), water (balance, >=70%)

Any additional notes or necessary information for CMC staff:

Optional: Photos, Safety Data Sheets, or any additional relevant documentation

ex: detailed inventory list, photos of waste, product SDS, documentation or operating procedures
One file only.
2 MB limit.
Allowed types: jpg jpeg png tif pdf doc docx ppt pptx xls xlsx.