Chemical Waste Recharge Authorization Form


This form authorizes EH&S to recharge the account specified below whenever a department representative signs a Materials Packing List (MPL), or whenever a Hazardous Materials Management Team member completes and signs an MPL for routine bulk material pick-ups (i.e., oil, photographic waste,etc.).

  1. To establish your Chemical Waste Disposal Account, complete this form, obtain an authorized signature.
  2. Email, fax, or mail the completed form to the Office of Environment, Health & Safety.

FAX number: 643-7595
Campus Address: EH&S, Banway Building, 2111 Bancroft Way, 4th Floor, MC 1150

Questions about this form or your recharge account? 

If you have any questions, please contact the Recharge Administrator at 642-3073 or e-mail at

Office of Environment, Health & Safety
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