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