Sharps Disposal Request

Sharps Disposal Request

Use this form to request collection and disposal of sharps containers

Name of Person requesting disposal*

Requestor's e-mail address

Building where sharps container is located*

Select or enter value

Room Number where Sharps container is located*

Contents of Container*

Sharpened steel (needles, blades)

Pipette tips (plastic)

Vials & tubes (glass)

Other

Contamination

Biohazardous materials

Hazardous chemicals

Radioactive materials

Identify the material(s) the sharps may be contaminated with*

Size of container*

1 quart

2 quart

1 gallon

2 gallon

>2 gallon

Number of containers*

Is a replacement container needed?*

Yes

No

Budget number for purchase of replacement container(s)*

Send me a copy of my responses

Powered by