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CEHS, Center for Environmental Health and Safety

Biological Pickup Request Form

Name:

E-mail:(must be filled in with YOUR e-mail or this form will not be received by staff)

Department:

Date:

Principal Investigator:

Phone:

Building/Room:    

Instructions for completing this form

Type of waste

Further Description:

# of Cont.

Weight (lbs)

PIMW?

Yes  No


Type of waste

Further Description:

# of Cont.

Weight (lbs)

PIMW?

Yes  No


Type of waste

Further Description:

# of Cont.

Weight (lbs)

PIMW?

Yes  No


Comments


 

Copyright © 1994-2003 Southern Illinois University
Center for Environmental Health and Safety
Phone: 618-453-7180
E-mail: info@cehs.siu.edu