Indiana State University

Office of Environmental Safety

Bio-Waste & Hazardous Chemical Waste Routing Form

 

Directions:  This inventory form is to be completed for all chemicals and other hazardous or special waste materials designated for disposal.  Each item indicated on this inventory should be properly labeled.  Call extension 4022 for pick-up and fax a copy of this form to extension 8460.

 

Date:  _______________________

Department:  ___________________

Contact Person: ______________

Building:  ______________________

Phone:  ______________________

 

 

Chemical/Waste Description

Hazard Classification

Quantity

Generator

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Inventory Prepared By:  _________________________________ Date:  _________

 

Office of Environmental Safety:  ___________________________  Date:  ________

 

Comments:  ___________________________________________________________________________

 

Office of Environmental Safety -  2, 2009