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Marshall University Environmental Health & Safety Unwanted Chemical Pickup Request Form In order to comply with state and federal hazardous materials regulations, all chemicals must be p

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Marshall University Environmental Health & Safety Unwanted Chemical Pickup Request Form

In order to comply with state and federal hazardous materials regulations, all chemicals must be properly labeled and stored Incompatible chemicals should never be stored together All chemical containers must have original label, or a replacement label with the full chemical name, not molecular formula, and all hazard warnings from original container (ex Toxic, Poison, Flammable) in words or symbols

Unwanted chemicals must have the “Unwanted Chemical Label” completely and correctly filled out and applied to the container Please date the label when waste is first added to the container

Keep unwanted chemicals in a separate area, segregated by compatibility, in secondary containment trays, preferably on shelves where they can be reviewed and identified Please do not store or package unwanted chemicals in cardboard boxes; packaging will be done at the time the chemical(s) is picked up from your facility

Email completed pickup request forms to douglas2@marshall.edu You will be contacted with a time frame for waste pickup For assistance with chemical compatibility, questions about completing the form, concerns about chemicals and chemical waste management contact Nathan Douglas in the Environmental Health & Safety office at the email above, or phone 696-3461

If no, indicate other storage locations      

Chemical Name

(% of each constituent if mixture)

Container Type

Number of Containers

Quantity

(Indicate Units)

State

(Solid, Liquid,

or Gas)

Is Product Reusable

Signature of Responsible Faculty/Staff Date Picked Up Page       of      

Trang 2

Principal Investigator/User       Building & Room No      

If no, indicate other storage locations      

Chemical Name

(% of each constituent if mixture)

Container Type

Number of Containers

Quantity

(Indicate Units)

State

(Solid, Liquid,

or Gas)

Is Product Reusable

Signature of Responsible Faculty/Staff Date Picked Up Page       of      

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