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HAZARDOUS WASTE PICKUP REQUEST

Instructions   
STEP 1 - Location and Contact Information

     

  Name:   Principal Investigator:  
Phone:   Email:   Dept:  
Building:   Room #s:   Facility:  
Comments:
 
STEP 2 - Containers for Pickup (one entry per chemical type)

Number  of Containers:   Container Size (# only):  Unit:    

Chemical Name:  
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