Weekly Pickup Schedule Waste Pickup Question Contacts: Jim Pyrz, Environmental Safety Manager, 319-335-4625 Generator Information Requestors First Name * Requestors Last Name * Department * Pickup Location Room Number * Pickup Location Building * Requestors Phone Number * Requestors E-mail Address * PI or Supervisor First Name * PI or Supervisor Last Name * Container Information - Enter a count of the number of containers for each waste typeIt is not necessary to enter a 0 in the field where you don't have that waste type. Only a container count is required. It is unnecessary to name all of your chemicals. Batteries Lead acid batteries must each have a label attached. All other batteries may be put in a sealed box with one label on the box or label individually. Please provide a count of the number of batteries. USED OIL - Total number of containers SOLIDS - Total Container(s) < 100 grams SOLIDS - Total Container(s) 100 - 500 grams SOLIDS - Total Container(s) 500 grams - 1 kilogram SOLIDS - Total Container(s) > 1 kilogram LIQUID - Total Container(s) < 1 gallon LIQUID - Total Container(s) 1 gallon LIQUID - Total Container(s) 5 gallon LIQUID - Total Container(s) 30 gallon LIQUID - Total Container(s) 55 gallon Gas - Total cylinder(s) Replacement Container(s) Needed? Contact EHS (5-4626) for prior approval. Comments and additional descriptions CERTIFICATION Check each box below as confirmation of each statement * Container is labeled correctly. Container is compatible with waste type. Container is not too full. Container is clean and free of contamination. I hereby declare that the identification/description of waste is accurate and complete, and that I have made a reasonable effort to minimize this waste. * Hawkid (If you do not have a Hawkid, add your intials) Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026