RADIOACTIVE WASTE COLLECTION REQUEST

Requested By:
Campus Phone Extension:
Email Address:
Project Number:

Waste Types

Number of Containers

Waste Location

Dry Solid Waste, Short Half-Life Container
Room Building
Dry Solid Waste, Long Half-Life Container
Room Building
Liquid Scintillation Vials, Boxed
Room Building
Bulk Liquid Scintillation Fluid
Room Building
Animal Waste
Room Building
Other, Please Describe
Room Building

If you have special instructions or comments, please indicate in the box below: