UC Irvine Chemical Waste Collection Request

This form should be completed to request pick-up of Chemical Waste. In most cases, chemicals submitted online will be collected within 3 working days.

  1. Complete all Waste Generator Information fields.
  2. Print a copy for your records.
  3. Click the "Next" button to submit.
  4. LABELS:  A second page will appear with a button to your Hazardous Waste Label. This label can serve as the container label, and should be printed and attached to the container prior to pick-up. There is also a button to request additional pickups.
Waste Generator Information:
*required fields
*Name: (first) (last)
*Phone:
*Principal Investigator: (first) (last)
*Department:
*Building:
*Room:
*Account: *Fund:

E-Mail:


Item Information:

* Constituent
(Use complete names ONLY. No formulas, abbreviations)
(For "trace" enter the concentration.)
Total of Percentages of Constituents must equal 100% .
» EXAMPLE:
*Percentage
(For "trace", please enter 0)
(Do not use a % symbol)
1.
%
2.
%
3.
%
4.
%
5.
%
6.
%
7.
%
8.
%
9.
%
10.
%
Total
   
* Physical State:
* Number of Containers:
* Weight/volume:
* Units:
* Major Hazard:
Flammable
Explosive		 Toxic
Air/Water Reactive		 Oxidizer
Corrosive
Second Hazard: (optional)
Flammable
Explosive		 Toxic
Air/Water Reactive		 Oxidizer
Corrosive
Additional Information: