Chemical Pickup Request Form

Safety and Environmental Management, Georgetown University
(202) 687-7172, safetyfirst@georgetown.edu
We are using a Google Form. Please contact us if you have any questions.
Version. 2.01
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    The pickup will be scheduled within three (3) weeks.

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    Please provide information of your chemicals: list every component and its percentage in the mixture in the box

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    * This form should not be used for emergency requests. In case of emergency, please call DPS at 202-687-4343 or 202-687-4357(HELP).

    * Please contact Facilities Management (7-3432) if you request key cuts, lock changes, eyewash repair, etc.

    Please review the following instructions:

    Inspect all waste containers. All containers used to collect hazardous waste must be affixed with a 'Hazardous Waste' label. SEM provides hazardous waste labels, if needed. * The 'Hazardous Waste' label must include the following information. It is required that each section of the label be completed including the - Accumulation start date. - Contains the words,'Hazardous Waste'. - Locations. - Accumulation start date - Chemical name of contents (full name, no abbreviation). If mixture, list all chemical names with their approximately percentage in the mixture. * All containers must be removed for proper disposal within 60 days from the accumulation start date. * For empty drums pickup, please cross-out the original label, and mark the container 'empty'. * DO NOT mix waste that is incompatible. Your cooperation and assistance is essential for our hazardous waste operation in compliance with Federal and District of Columbia Rules and Regulation. Thanks.