SPO Infectious Waste Pick-Up Form
Contact: SPO (215-898-8760)
e-mail: planops@mail.med.upenn.edu
Space Planning & Operations
Perelman School of Medicine at the University of Pennsylvania
REGISTRATION FORM
Instructions: Please use this form to request pick up of infectious (biohazardous) waste. Pick up will
occur on a scheduled basis or according to need. Please note that all infectious waste must be
autoclaved for a half hour to an hour. Each bag must be closed with autoclave tape. For more
information, refer to the website of Environmental Health & Radiation Safety at www.ehrs.upenn.edu or call
Space Planning & Operations at 215-898-8760. Thank you.
Department Name:
equest Form
Requestor Name:
Contact: SPO (215-898-8760)
Phone Number & e-mail:
e-mail: planops@mail.med.upenn.edu
Pennsylvania
Building:
Address/Mail Code:
Space Planning & Operations
Date:
Perelman School of Medicine at the University of
Building:
Department Name:
Department Name:
Building:
Location of Autoclave:
(Building &Name:
Room Number)
Requestor
Address/Mail Code:
Phone
Number
e-mail:
Preferred
Day &
and
Time of Pick-up
Date:
Principal Investigator:
Building:
Department Name:
Business Administrator:
Location of Autoclave:
(Building & Room Number)
Phone Number:
e-mail:
Preferred
and Time
of Pick-up
Signature Day
of Principal
Investigator:
SUBMIT THIS FORM VIA E-MAIL TO: planops@mail.med.upenn.edu
Principal Investigator:
OR FAX IT TO: 215-573-2237
Business Administrator:
Phone Number:
Signature of Principal Investigator:
e-mail: