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Pick-up Request for Chemical Materials

Use this form to request pick-up of chemical materials only.
This form is NOT for pick-up of radioactive materials nor biohazardous materials.

Person who generated materials:

Phone:

First Name of person authorizing pickup:

Last Name of person authorizing pickup:

Phone:

Email Address:

UAMS ID Badge Barcode Number or SAP ID Number of person authorizing pickup:

This is the number beneath the barcode on your UAMS Student or Employee ID Badge.
Your SAP ID number is found in the upper right hand corner of your UAMS ID.
Your First Name and Last Name must match the name listed for you in SAP.

Fund:

 

Cost Center:

OR

WBS Element:

Dept Business Officer:

NOTE: We cannot accept Federal Grant funds (211-219) per UAMS Policy 8.3.17.
 
Please do not remove materials from area where they were generated. Be sure that each item is packaged and labeled clearly. If you do not know the chemical composition of an item you must identify it at least qualitatively. It is against State and Federal Law for Occupational Health and Safety to accept unknowns into the Hazardous Materials/Waste Management Program. By law, it is the responsibility of the generator to identify materials they generate. Please contact Occupational Health and Safety for any needed help in this regard.

Building:

Room Number: