HAZARDOUS WASTE LABEL HAZARDOUS WASTE LABEL

Bldg/Rm #: Lab Group or Dept.: Bldg/Rm #: Lab Group or Dept.:

Contact Person: Phone #: Contact Person: Phone #:

COMPOSITION OF WASTE: Please list ALL chemicals and % composition (including water). DO NOT COMPOSITION OF WASTE: Please list ALL chemicals and % composition (including water). DO NOT
USE ACRONYMS OR ABBREVIATIONS! USE ACRONYMS OR ABBREVIATIONS!
Waste Name: Waste Name:
Chemical Name: % Composition: Chemical Name: % Composition:
% %
% %
% %
% %
% %
I certify this information is true, Please circle the hazards of this waste. TOTAL: 100% I certify this information is true, Please circle the hazards of this waste. TOTAL: 100%
accurate, and in compliance with accurate, and in compliance with
IUEHS label instructions. I have made IUEHS label instructions. I have made
my best effort to reduce the volume my best effort to reduce the volume
and toxicity of waste generated. and toxicity of waste generated.

Signature:_____________________________________________Date: Signature:_____________________________________________Date:
To request a pick-up visit: https://protect.iu.edu/environmental-health/public-environment/index.html To request a pick-up visit: https://protect.iu.edu/environmental-health/public-environment/index.html

HAZARDOUS WASTE LABEL HAZARDOUS WASTE LABEL

Bldg/Rm #: Lab Group or Dept.: Bldg/Rm #: Lab Group or Dept.:

Contact Person: Phone #: Contact Person: Phone #:

COMPOSITION OF WASTE: Please list ALL chemicals and % composition (including water). DO NOT COMPOSITION OF WASTE: Please list ALL chemicals and % composition (including water). DO NOT
USE ACRONYMS OR ABBREVIATIONS! USE ACRONYMS OR ABBREVIATIONS!
Waste Name: Waste Name:
Chemical Name: % Composition: Chemical Name: % Composition:
% %
% %
% %
% %
% %
I certify this information is true, Please circle the hazards of this waste. TOTAL: 100% I certify this information is true, Please circle the hazards of this waste. TOTAL: 100%
accurate, and in compliance with accurate, and in compliance with
IUEHS label instructions. I have made IUEHS label instructions. I have made
my best effort to reduce the volume my best effort to reduce the volume
and toxicity of waste generated. and toxicity of waste generated.

Signature:_____________________________________________Date: Signature:_____________________________________________Date:
To request a pick-up visit: https://protect.iu.edu/environmental-health/public-environment/index.html To request a pick-up visit: https://protect.iu.edu/environmental-health/public-environment/index.html