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OUHSC, 271-1606 OUHSC, EHSO@Ouhsc.Edu OU-NORMAN DEPARTMENT: UNIVERSITY OF OKLAHOMA PRINCIPAL CAMPUS ENVIRONMENTAL HEALTH AND SAFETY OFFICE INVESTIGATOR: ADDRESS: PHONE # HAZARDOUS MATERIALS PICK-UP REQUEST FORM INVENTORY OUHSC (FAX 271-1606) (Office 271-3000) SUPERVISOR: PHONE # OU Norman (FAX 325-7172) (Office 325-2212) EHSO Use Only DESCRIPTION OF CONTENTS SOLID/ 1. Chemical or common name and CAS# of all substances over 1% by Waste Barrel Lab Pack/DOT LIQUID/ PURE/ PRIMARY volume Date Number Hazard Code ROOM DEPT CONTAINER GAS MIXTURE HAZARD 2. Strength (concentration) of individual substance, where applicable. NUMBER CODE* NUMBER AMOUNT (S/L/G) (P/M) CODE 3. Percentages of mixed chemicals in container (by volume) Example : 301 ES 1 4 liters L M F 20% Toluene 108-88-3 80% Xylene 1330-20-7 Hazard Codes: C-Corrosive E-Explosive F-Flammable HT/C-Highly Toxic/Carcinogenic This is to certify that the above named materials are properly I-Irritant O-Oxidizer R-Reactive classified, described, packaged, marked and labeled and are in proper condition for the transportation according to the applicable *See reverse for Department Code listing requirements of the University of Oklahoma Environmental UPON COMPLETION, PLEASE: Health and Safety Office. FAX TO: EMAIL TO: OUHSC, 271-1606 OUHSC, [email protected] Signature of Authorized Department Representative EHSO USE OU-NORMAN, 325-7172 OU-NORMAN, [email protected] Pick Up Number: ______________________________ Waste Generated (in lbs.)=_______________________ DEPARTMENTAL CODES-Health Sciences Center Campus (SCC) Peggy & Charles Stephenson (AHB) Allied Health Building (SU) David L. Boren Student Union (OAC) Oklahoma Allergy Clinic Cancer Ctr (BSEB) Basic Sciences Education Building (DMEI) Dean A. McGee Eye Institute (OCI) OU Cancer Institute (SCB) Service Center Building (BRC) Biomedical Research Center DCSB) Dental Clinical Sciences Building (CHP) OU Children's Physicians (SWCP) Steam & Chilled Water Plant (BMSB) Biomedical Sciences Building (DEH) Don E. Hogg Greenhouse (OUCPB) OU Children's Physicians Building (SP) Student Pavilion (CPD) Campus Police Station (FH) Faculty House (OUP) OU Physicians Building (UHC) University Health Club (CSC) Child Study Center (FMC) Family Medicine Clinic (OUSC) OU Surgery Center (UTF) University Transit Facility (CH) Children's Hospital (FRS) Fort Reno Science Park, El Reno, OK (PPB) Presbyterian Professional Building (VA) Veterans Affairs Medical Center (CHB) College of Health Building (WP) G. Rainey Williams Pavilion (PT) Presbyterian Tower (WHS) Warehouse Facility (CNB) College of Nursing (HHODC) Harold Hamm Oklahoma Diabetes Center (RT) Radiation Therapy Facility (CPB) College of Pharmacy (DC) Mark Allen Everett Dermatology Building (RP) Research Park, 655 Research Parkway (CMRB) Comparative Medicine Research Resource Bldg (MP) Motor Pool (LIB) Robert M. Bird Health Sciences Library (CMA) Comparative Medicine Annex (ORB) O'Donoghue Research Building (ROB) Rogers Building Departmental Codes-Norman Campus (ACM) Asbestos Containing Material (CMC) Catlett Music Center (GHC) Goddard Health Center (PRTS) Printing Services (AD) Athletic Department (CPH) Copeland Hall (GLCH) George Lynn Cross Hall (PP) Physical Plant (AFH) Animal Holding Facility (CRAD) Craddock Hall (JAGC) Jimmie Austin Golf Course (PS) Paint Shop (AH) Adams Hall (CSKF) Ceramics Studio & Kiln Hall (LAND) Landscaping (PYS) Psychology (ARM) Armory (EL) Engineering Laboratory (LNC) Lloyd Noble Center (RH) Richards Hall (ARS) Archaeological Services (ES) Environmental Services (MUD) Mechanical Engineering Mud Lab (RHYN) Rhyne Hall (BH) Buchanan Hall (FAC) Fine Arts Center (NEL) Nuclear Engineering Laboratory (SEC) Sarkeys Energy Center (BL) Bizzell Memorial Library (FH) Felgar Hall (NH) Nielson Hall (SRTC) Stephenson Research and (BS) Biological Station (FJC) Jones Art Center (OMNH) Sam Noble Oklahoma Museum of Technology Center (CC) Columns Commissary (FL) Fears Structural Engineering Lab Natural History (NWC) National Weather Center (CEC) Carson Engineering Center (FR) Fisheries Research (PHSC) Physical Sciences Center (CHB) Chemistry Building (GH) Gould Hall (PRP) Properties.
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