Western Kentucky University

Environment, Health and Safety

Regulated Waste Pick-up Request

GENERATOR INFORMATION




Waste Origin:              
Classification:        
One or more of the containers listed below contains:   PCBs   Radioactive Materials   Biohazardous Materials   None of the Above
Tag # Container
Type
Container
Size
Physical
State
Waste Description
~ OR ~
Click here to download the template (.xlsx format) for the alternate list of waste containers

Clicking the "Submit Request Now" button below will e-mail a copy of this form to Larry Page and will display a copy of the form that you can print for your records.
For security reasons, this form will no longer e-mail a copy to you.

 

 Last Modified 7/22/13