Request a Radioactive Waste Pickup

General Information

Complete this request with information from all containers to be picked up.ÌýUse this form for up to 5 containers at a time. If you have more than 5, submit more than one form or use the fax form.

Waste containers will only be picked up if certain items have been completed. Please make sure you complete the following:

  • Tags on full containers completed with waste information
  • Tags on full containers signed
  • Contamination survey results noted on tag

Radiation SafetyÌýmust receive this form by noon on Tuesday for pick-up on the following Wednesday morning.

If you have questions,Ìýcontact us.

Waste Pickup Request Form

Indicates required field
Have wipes been taken on all containers?
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Container 1
Isotopes & Total Activity (mCi)
#1
#2
#3
Do you need an empty container to replace this one?
Ìý
Ìý
Container Color
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Enter the items and % by volume in your waste. The percentages must equal 100%. Example for a liquid: "Tris 50%, water 25%, ethanol 25%"
Container 2
Isotopes & Total Activity (mCi)
#1
#2
#3
Do you need an empty container to replace this one?
Ìý
Ìý
Container Color
Ìý
Ìý
Ìý
Enter the items and % by volume in your waste. The percentages must equal 100%. Example for a liquid: "Tris 50%, water 25%, ethanol 25%"
Container 3
Isotopes & Total Activity (mCi)
#1
#2
#3
Do you need an empty container to replace this one?
Ìý
Ìý
Container Color
Ìý
Ìý
Ìý
Enter the items and % by volume in your waste. The percentages must equal 100%. Example for a liquid: "Tris 50%, water 25%, ethanol 25%"
Container 4
Isotopes & Total Activity (mCi)
#1
#2
#3
Do you need an empty container to replace this one?
Ìý
Ìý
Container Color
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Ìý
Enter the items and % by volume in your waste. The percentages must equal 100%. Example for a liquid: "Tris 50%, water 25%, ethanol 25%"
Container 5
Isotopes & Total Activity (mCi)
#1
#2
#3
Do you need an empty container to replace this one?
Ìý
Ìý
Container Color
Ìý
Ìý
Ìý
Enter the items and % by volume in your waste. The percentages must equal 100%. Example for a liquid: "Tris 50%, water 25%, ethanol 25%"