Indiana State University

Office of Environmental Safety

Bio-Waste & Hazardous Chemical Waste Routing Form


Directions:  This inventory form is to be completed for all chemicals and other hazardous or special waste materials designated for disposal.  Each item indicated on this inventory should be properly labeled.  Call extension 4022 for pick-up and fax a copy of this form to extension 8460.


Date:  _______________________

Department:  ___________________

Contact Person: ______________

Building:  ______________________

Phone:  ______________________



Chemical/Waste Description

Hazard Classification
















































Inventory Prepared By:  _________________________________ Date:  _________


Office of Environmental Safety:  ___________________________  Date:  ________


Comments:  ___________________________________________________________________________


Office of Environmental Safety -  2, 2009