Youngstown State University
Chemical Management Center Chemical Waste Form
To be filled out by department
| Bldg/Room# | User(Professor,etc.) | ||
| Transporter: | Use:(Research,Class#): | ||
| Main contents(by percentage): | |||
| Quantity: | |||
| Date: | Reason for disposal: A. B. C. D. E. (Circle only one) | ||
| User Signature: | Trasnsporter signature: | ||
To be filled out by CMC
| Container ID# | Filing code: |
Disposal Key
A=contaminated
B=chemical still usable but not needed
C=broken container
D=not usable, (circle one: outdated, solidified, precipitated, solid caked, hydrated)
E=product waste