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Chemical Pickup Request Form Instructions

Web Hint:

  1. When filling out a form online, instead of clicking from one form box to the next, press the 'tab' button and it will automatically take you to the next field. This also highlights anything already in the field and is deleted when you begin typing. To go back up to a previous field, press 'shift' and 'tab.'

  2. If you need more spaces, click the back button on your web browser after submitting the information. This will store all your previously typed information on the form so you won't have to retype 'Name,' 'Department,' etc.

Pickup form guidelines:

  1. If a chemical is still in good usable condition, please mark it as redistributable on the form in the chemical name section. Do not put any waste labels on it. We will pick the chemical up as product and try to find someone who can use it.
  2. All chemical waste must be in an appropriate sealed container with the proper lid. Labels must be typed or clearly printed. Please use the self-adhesive labels provided by CEHS (see Chemical Waste Management Guide).
  3. We ask that waste organic solvents be placed in a Jerrican provided by CEHS. Use the form "Chemical Inventory Analysis for Bulk Wastestreams" (green form) to have this waste collected.
  4. Use this form for all other chemical waste. If you need to use multiple forms, please use original forms only.
  5. If your waste is biologically or radioactively hazardous, do not use this form. If you need further disposal procedures for this type of waste, please contact CEHS.
  6. UNKNOWNS ARE NOT ACCEPTED BY CEHS. Please contact the Chemical Waste Manager for information on proper procedures for disposal. Try not to remove unknowns from their place of discovery. This may aid in our investigation.
  7. Each area has a unique Location ID# which should be placed on the pickup form. This number can be located on the inside cover of your Chemical Waste Management Guide. If there is not one in your guide or you don't have a guide, please contact the Chemical Waste Manager at CEHS.
  8. The column for spent/unused option is referring to whether the chemical's) have been used for their intended purpose. This is used by CEHS to give the correct EPA hazard code. The following is an example for clarification: If a researcher has 55G of formaldehyde solution and used 40G for pickling while not using the other 15G, the 40G would be considered spent and the 15G would be considered unused.
  9. In the amount/container column we ask for all units to be in pounds. This does include liquids. Due to this, the weight need only be listed as an estimate, not an exact amount (i.e. 1lb). EPA reports are made in pounds produced each year by hazard class which combines both liquids and solids.
  10. Pickups are made twice each week. Your waste will be collected in less than five working days from the date we receive the completed form.
  11. RETURN COMPLETED FORM TO:
			Chemical Pickup Requests
			Center for Environmental Health and Safety
			Mailcode 6898

           

EXAMPLE

NAME(PRINT) John Billing BUILDING/ROOM # Physical Sciences - 254 TELEPHONE # 453-6971

SHADED AREA FOR CEHS USE ONLY

Location ID # (required) 0157 DEPARTMENT Plasma Physics DATE 11/1/94 DATE RCVD. DATE COLLECTED
# of
Cont.
S=Spent
U-Unused
L=liquid
S=solid
G=gas
CHEMICAL NAME(S): indicate concentrations, if applicable (grams/liter, %, ppm, etc.) Amount/ Container (Pounds) REF # Actual Amount (lbs.) Cont.
Size
(G)
Cont.
Type
Storage
Code
DOT Hazard Div. EPA Code(s)

2

U

S

Silver Nitrate, redistributable (sealed container) .25  lbs.              

3

S

L

60% Phenol, 40% Chloroform 2.0 lbs.              

1

S

S

Lab Utensils Contaminated with Ethidium Bromide .5 lbs.              

4

U

S

Phosphorus Pentoxide (17 years old) 1.2 lbs.              
 


 

 


 
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Center for Environmental Health and Safety
Phone: 618-453-7180
E-mail: info@cehs.siu.edu

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