Radioactive Waste Disposal Request Form

 

Please read and follow these instructions carefully -

  • Please fill out the form completely - incomplete forms will result in pickup delays.

  • Room must be the location of the waste.

  • Under Types of Radioactive Waste enter either Solid or Liquid or Vials or other and the corresponding number of containers needed.

  • Paperwork must be completed.

  • Once the form is submitted, a copy of the information is sent to you and the concerned persons through e-mail.

  • If you have any questions, please contact EH&S at 742-3876.

Requestor Name:
Enter your Name
Requestor Phone No:
Enter your phone number (xxx-xxx-xxxx)
Department:
Enter your department name
Room No:
Location of the waste
Email:
Enter your email (eg. Kris.Ray@TTU.EDU)
Types of Radioactive Waste:
 		   # of Containers 
   # of Containers 
   # of Containers 
   # of Containers 
(eg. Solid)                       (eg. 4)
Is the Paperwork Completed? Check the appropriate one
Additional Information:
Additional information (optional)