Biohazardous/Medical Waste Pickup Request

Complete the form below to request pick-up of Biohazardous/Medical Waste only. Please note that this form is not to be used to request pickup of chemical hazardous waste or radioactive waste. All relevant fields are required to be completed.

For more information about Biohazardous/Medical waste, please contact Waste Management (951) 827-5528.

✻ = Required

Name (First and Last): ✻

Phone Number: ✻

Email ✻

Principal Investigator (First and Last Name): ✻

Location (building, room #): ✻

Item Information

Do you have biohazard waste bags for pickup?

Yes No

Number of bags:

Bag size:

Do you have medical waste for pickup?

Yes No

Number of containers:

Container size:

Do you have sharps containers for pickup?

Yes No

Number of containers:

Container size:

Are any of your sharps contaminated with hazardous chemicals? If "Yes," please use the Online Tag Program to request pickup of those specific sharps containers

Yes No

Do you need replacement sharps containers?

Yes No

If "Yes," please specify how many 1-quart and/or 2-gallon containers you need: