Regulated Waste Label Request

First Name

Last Name

Telephone

RPI Telephone (XXX-XXX-XXXX)

RPI Email

Number of Hazardous Waste (Chemical Waste) Labels Requested

Number of Universal Waste (Batteries, Used Bulbs) Labels Requested

Pick Up or Delivery

Pick up the requested labels at Cogswell 221

Have the requested labels delivered to me (provide location below)

Delivery Location

Comments