Donation of Chemicals to UMDNJ Chem-Mart
EOHSS Waste Minimization Chemical Redistribution Program for the Newark and Piscataway Campuses
Instructions: Please complete the information requested below to donate chemicals that are unopened, uncontaminated and unexpired.
DONATOR'S INFORMATION Your Name: Department Room/Bldg where Chemicals are Located : Your Email : Your Phone Number : PI Name: Campus (NB or Newark) Provide the following information for the submission: Contents: Chemical or Product Name Size of the Container(s): (e.g., 4 liters) Number of Chemical Containers: (e.g., 15) This form will be submitted to EOHSS. If you have questions about this form submission, please e-mail to Kyle San Giovanni or call 973-972-3411 or 2-3411 Please use the TAB key only to move between the fields. Item No. Chemical or Product Name Size of the Container(s) Number of containers 1 2 3 4 5 6 7 8 9 10
DONATOR'S INFORMATION
Your Name:
Provide the following information for the submission: Contents: Chemical or Product Name Size of the Container(s): (e.g., 4 liters) Number of Chemical Containers: (e.g., 15)
This form will be submitted to EOHSS. If you have questions about this form submission, please e-mail to Kyle San Giovanni or call 973-972-3411 or 2-3411 Please use the TAB key only to move between the fields.
Chemical or Product Name
Size of the Container(s)
Number of containers
1
2
3
4
5
6
7
8
9
10