Hazardous Materials Shipping Requests

To request EHS assistance with shipping hazardous materials off-campus or across campus complete the form below:

Full name
E-mail address
P.I. or Supervisor
Department
Phone number
Building (where the material is)
Room number (or location of where the material is)

Sample composition(s); phase(s); quantity(ies) and unit(s) Example: 1)1,2-Dichlorobenzene; solid; 5 mg 2)Sodium hydroxide solution, 50%; liquid; 10 mL

Dry ice?	Yes   No
Quantity of dry ice (in kg)
Courier
Recipient name
Recipient E-mail
Recipient Phone

Recipient's Address:

On what date would you like to ship?
Which dept pays for the shipping? (include grant number and/or account number)