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Hazardous and Radioactive Materials Request for Disposal Form

University of Wyoming Operations Safety Office
Regulated Materials Management Center

Phone: 307-766-3697

This form is used to generate a request for Hazardous Materials Disposal at the University of Wyoming. Please fill this form out completely! Incomplete requests will not be processed by the computer system.

NOTICE: Most (>95%) of chemical waste disposals are completely free for UW supported academics and research. The Safety Office covers these costs.
Biohazardous waste disposal (blood, animal tissues, etc.) may have a charge.
Radioactive waste disposal may have a charge.
Please contact us with any questions about disposal costs.

Required fields marked with *
Responsible Party/Faculty/Staff:
Person preparing this form:
Your office number: Building Name:
Phone: Date of request:
Your email:
Waste Generating Activity*

The finance folks need to know whether waste is from:
Academic- Waste produced in undergraduate/graduate teaching labs or classrooms.
Athletics- Waste produced by the Athletic Department.
Cooperating Agency - Waste produced by non-University agencies in cooperation with Campus, i.e.
WY Game and Fish, State Vet Lab, WY Coop.

Services - Waste produced by University support services, i.e. Physical Plant, Student Health.
Supported Research - Waste produced by grant supported research.
Unsupported Research - Waste produced in non-grant supported research.
Location of Waste (Building/Room No.):*
Has the chemimical Waste been labeled?
Do you need empty waste containers brought to you

 Please enter the number of items to be disposed of
** For each applicable row below, the description field is mandatory.
Description of Hazardous Materials 
List components and percent compositions of mixtures. A good guess is adequate, however, concentrations could affect disposal costs.
(Ex: 90% Acetone, 10% Water*

Count of Container

 Container Type
jar, etc)

(e.g., gallon, liter, gram, kilogram)

Physical State

1000 E. University Ave. Laramie, WY 82071
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