CSUN Hazardous Waste Transfer Form

CSUN Hazardous Waste Transfer Form

Please submit this form to EH&S at least 48hrs prior to a scheduled waste pickup.

Your Information

Your Name*

Date of pickup*

Please visit our website to schedule a pickup if you have not already done so.

Phone number / Extension

Email*

Department*

Select or enter value

Building*

Select

Room/Location*

Source*

Research

Instructional

Physical Plant Management

Funding*

How is your research being funded?

Internal

External

Types of Waste*

Select all that apply.

Select

Items Requiring Special Consideration*

Please Identify if your pickup contains any of the following materials.

NOTE: You will still need to enter line items for these materials in the "Description" field below.

Select all that apply.

Select

Total Number of Containers*

Description*

Please list one waste type per line. Include:

You may use this template (excel spreadsheet), and then copy and paste from the template into the box below.

Photo(s)*

Please upload one or more photos of the waste to be picked up.

Drag and drop files here or