General Information

Complete this request with information from all containers to be picked up. Use this form for up to 5 containers at a time. If you have more than 5, submit more than one form or use the fax form.

Waste containers will only be picked up if certain items have been completed. Please make sure you complete the following:

  • Tags on full containers completed with waste information
  • Tags on full containers signed
  • Contamination survey results noted on tag

Radiation Safety must receive this form by noon on Tuesday for pick-up on the following Wednesday morning.

If you have questions, contact us.

Waste Pickup Request Form

Container 1
Isotopes & Total Activity (mCi)
Enter the items and % by volume in your waste. The percentages must equal 100%. Example for a liquid: "Tris 50%, water 25%, ethanol 25%"