Hazardous Waste Manifest Form

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Manifest #
Middlebury College Bicentennial Hall
Hazardous Waste
Internal Manifest
Date Entered:
Disposal Date:
All hazardous waste disposal must be in accordance with applicable Vermont and Federal guidelines and Middlebury College’s standard
operating procedures. Separation of wastes to avoid unwanted reactions in accumulation containers is required. Please contact the
Director of Science Support Services at Ext. 5421 for more information. Please check with Tom Sheluga before removing the waste from your lab.
Responsible Individual: ____________________________________________________
Laboratory Location: ___________________
Wastes generated by laboratory processes:
# of
Total
Waste Identity
conts
quant
List hazardous or regulated components, or waste profile name/number
Surplus and off-spec laboratory chemicals in original containers:
# of
Total
Chemical Name
conts.
quant
# of
conts.
Total
quant
pH
Process generating
waste
Chemical Name
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