WASHINGTON UNIVERSITY SCHOOL OF MEDICINE

ENVIRONMENTAL HEALTH & SAFETY



On-Line Chemical Request For Pick-Up

ATTENTION: Improperly labeled, unlabeled, radioactive and infectious substances will not be accepted.
IMPROPERLY DOCUMENTED OR UNKNOWN MATERIALS WILL BE ANALYZED AT GENERATOR'S EXPENSE.

Request Date:11/23/2009 12:50:11 AM
First Name:
Last Name:
Email Address:
Department Name:
Division Name:
Dept. or Divn. Billing #:
Name of P.I.
Campus Box:
Work Phone:
Building:
Enter Building if not on
"Select a Building" list:
Room Number:
Chemical Disposal Guidelines

Chemical Name or Consituents:
% Composition (if applicable),
no trade names (unless constituents are included), no acronyms
Number of Containers
Physical State
Weight or Volume of container (liters or grams)

Comments:







FACILITY INFORMATION:
WASHINGTON UNIVERSITY SCHOOL OF MEDICINE, ENVIRONMENTAL HEALTH & SAFETY
CAMPUS BOX 8229
660 SOUTH EUCLID AVENUE,
ST. LOUIS, MO 63110-1093
EPA# MOT300010857
MDNR 01591
Phone: (314) 362-6816 or (314) 362-1028
Fax: (314) 362-1095