Request for Chemical Removal
(Instructions)
- Determine if you can neutralize, detoxify or recycle it yourself. If you can, there is
no need to fill out this form. Refer to the Laboratory
Safety Manual for guidelines.
- Separate solids from liquids.
- Containerize it. Containers shall be compatible with the chemical(s), shall be sturdy,
leak-proof, have a tight cap/lid/seal, and clean on the outside. Unless other arrangements
have been made, all containers must be 5-gal. or less in volume. Milk jugs or other food
containers, thin trash bags, biohazard bags, radioactive bags, 5-gal. thin-walled metal
solvent cans, 5-gal. glass carboys are NOT to be used.
- Label the containers with label HM-95-2. {Available from EHS}
- List ALL the chemical constituents with approximate percentages. Heavy metals should be
listed in mg/l or ppm if under 0.1%.
- Do not use abbreviations or chemical symbols. Use common or IUPAC chemical names.
- If applicable, list trade name and chemical constituents. If necessary, include a
copy of the MSDS.
- For pesticides, list the common name and the chemical name.
- Refer to the Laboratory Safety
Manual for guidelines if you do not know what is in the container. (EHS will not pick
up unidentified chemicals, i.e., "unknowns.")
- Number each container.
This number contains a departmental abbreviation (found in Laboratory Safety Manual, Appendix H), (dash),
date, (dash), consecutive container number. For example: [CHEM-010293-001 -- Department is
Chemistry, date is Jan. 2, 1993, container number is one.]
- Fill out this form. Mail or deliver completed form to Environmental Health & Safety
Department.
- Generator Information. The responsible faculty/staff person is the person who is in
charge of the laboratory/maintenance site. The contact person is the person whom EHS would
contact about the chemicals.
- Identification/Description of the Chemicals.
- List all components and their respective percentages. Do not use chemical symbols
or abbreviations.
- List physical state and pH, if applicable. (pH paper is adequate.)
- List number and type of containers.
- List volume (liquids) or weight.
- List any hazards associated with this material, e.g., flammable, oxidizer, organic
oxidizer, poison, corrosive, water-reactive, pyrophoric, mutagen/teratogen, carcinogen,
shock-sensitive, etc.
The chemicals must be prepared for pickup before sending this form to EHS. The
request will be processed as it arrives. Chemicals that are improperly packaged, labeled,
or identified will not be picked up. Pickup can be expected within two weeks of
receipt by EHS. This form must be filled out as completely, specifically and legibly as
possible (please print or type). Improperly, inadequately, or illegibly prepared forms
will be returned for completion/clarification. If you have questions, a request of special
urgency, or if EHS has not picked up your chemicals within two weeks, please
call EHS at 744-7241.
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