Site Map of Manual
Lab Safety Manual
1st Page
Chapter 1
Emergency
Response
Chapter 2
General
Safety
Chapter 3
Chemical
Hygiene Plan
Chapter 4
Radiological
Safety
Chapter 5
Biological
Hygiene Plan
Chapter 6
Laser
Safety
Chapter 7
Administrative
Concerns
Chapter 8
Standard
& Special Operating Procedures
Chapter 9
Facility
Data
Appendicies
Bibliography
Glossary
Index
On-Campus Contact Information
1st Rule of Lab Safety
Haz-Waste No-No
|
Updated February
2003
Appendix K
Examples of Chemical Removal Request Forms
Example of Chemical Surplus Removal Request
Form (opens in new window)
Determine if
you can neutralize, detoxify or recycle it yourself. If you can, there is no need to fill
out this form. Refer to the Laboratory Safety Manual for
guidelines.
Separate
solids from liquids.
Containerize
it. Containers shall be compatible with the chemical(s), shall be sturdy, leak-proof, have
a tight cap/lid/seal, and clean on the outside. Unless other arrangements have been made,
all containers must be 5-gal. or less in volume. Milk jugs or other food containers, thin
trash bags, biohazard bags, radioactive bags, 5-gal. thin-walled metal solvent cans,
5-gal. glass carboys are NOT to be used.
Label the containers with label HM-95-2. {Available from
EHS}
- List
ALL the chemical constituents with approximate percentages.
 Heavy metals should
be listed in mg/l or ppm if under 0.1%.
- Do
not use abbreviations or chemical symbols. Use common or IUPAC chemical names.
- If
applicable, list trade name and chemical constituents. If necessary, include a copy
of the MSDS.
- For
pesticides, list the common name and the chemical name.
- Refer
to the Laboratory Safety Manual for guidelines
if you do not know what is in the container. (EHS will not pick up unidentified chemicals,
i.e., "unknowns.")
Number each container. This number
contains a departmental abbreviation (found in Laboratory Safety
Manual, Appendix H), (dash), date, (dash), consecutive container number. For example:
[CHEM-010293-001 -- Department is Chemistry, date is Jan. 2, 1993, container number is
one.]
- Fill
out this form. Mail or deliver completed form to Environmental Health & Safety
Department.
Generator
Information. The responsible faculty/staff person is the person who is in charge of the
laboratory/maintenance site. The contact person is the person whom EHS would contact about
the chemicals.
- Identification/Description
of the Chemicals.
- List all
components and their respective percentages. Do not use chemical symbols or abbreviations.
- List
physical state and pH, if applicable. (pH paper is adequate.)
- List
number and type of containers.
- List
volume (liquids) or weight.
- List
any hazards associated with this material, e.g., flammable, oxidizer, organic oxidizer,
poison, corrosive, water-reactive, pyrophoric, mutagen/teratogen, carcinogen,
shock-sensitive, etc.
The
chemicals must be prepared for pickup before sending this form to EHS. The request
will be processed as it arrives. Chemicals that are improperly packaged, labeled, or
identified will not be picked up. Pickup can be expected within two weeks of
receipt by EHS. This form must be filled out as completely, specifically and legibly as
possible (please print or type). Improperly, inadequately, or illegibly prepared forms
will be returned for completion/clarification. If you have questions, a request of special
urgency, or if EHS has not picked up your chemicals within two weeks, please
call EHS at 744-7241.
Download Form as MS Word 2000 document
Download Form in pdf format |
Bibliography
