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
*
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
Size of container
*
1 quart
2 quart
1 gallon
2 gallon
>2 gallon
Number of containers
*
Is a replacement container needed?
*
Yes
No
*
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