Washington State University Home
environmental services/hazardous waste
Chemical Collection Request
Generator Information
Name:
Phone:
Mail stop:
Building:
Room:
Your Email:
EXAMPLE:
Item
Constituents
Percentage
1
Methanol
90
2
Ethanol
5
3
Water
5
Total
100%
Constituents
Complete names
ONLY
.
No formulas, abbreviations
Percentage
(Do not use a
'%'
symbol)
(For "trace", please enter 0
then place the concentration in the constituent column)
1
%
2
%
3
%
4
%
5
%
6
%
7
%
8
%
9
%
10
%
Total
%
Physical State:
_ Select Physical State _
Solid
Liquid
Gas
Number of Containers:
_ Select Number of Containers _
1
2
3
4
5
6-10
Weight/Volume:
Units:
_ Select Size of Container (Units) _
mg
g
kg
ml
Liter
Pint
Gallons
Major Hazard:
Flammable
Poison
Oxidizer
Explosive
Air/Water Reactive
Corrosive
Secondary Hazard:
(Optional)
Flammable
Poison
Oxidizer
Explosive
Air/Water Reactive
Corrosive
Additional Information
Environmental Issues
|
Hazardous Materials / Wastes
Public Health
|
Resources
|
Workplace Safety
|
Training
Personnel
|
Statewide EH&S
|
S P P M
|
WSU Home
Comments and questions:
ehs@wsu.edu
Copyright
@ Washington State University.
Disclaimer
Electronic Publishing and Appropriate Use Policy
URL: http://www.ehs.wsu.edu/ccr/indexccr.asp
Revised
4/05/04
Reviewed
11/02/05
