Reference Number:
(please allocate a number to each
container and label)
UNKNOWN LABORATORY WASTE CHEMICAL ASSESSMENT
FORM
Customer Site Details for University
of Glasgow
School
Name
School
Address
Address where waste
held
Post Code
Post Code
Site
Contact Name (if
different)
Site
Telephone No.
Customer
Contact Name
Customer
Telephone No.
Nature of
Business
Higher education & research
Unknown Details
Size of
Container (g/ml)
Quantity in
Container (g/ml)
Form (eg
solid/liquid/gas)
Colour
Label Description
(e.g. trade name,
part name on label,
code, etc.)
Probable source of
material (e.g. byproduct, unused
material, etc.)
Container
Condition
Process from
which material
originated
On Site Assessment if you are unsure about safely identifying the answers to the
following you should contact the University Chemical Safety Adviser
SOLID
LIQUID
Fuming
If yes; pH of the fumes
(with damp pH paper)
pH (press damp pH strip
against material)
Solubility in water
Detectable Odour
Oxidiser (Starch Paper)
General description
(e.g. Lumps, crystals,
metallic, density, etc.)
Yes/No
Yes/No/Partial
Yes/No
Fuming
If yes; pH of the fumes
(with damp pH paper)
Mixes with water
Yes/No
pH (on neat material)
If neutral – pH with damp
pH strip
If reading still neutral –
mix 1:1 with water - pH
General description (e.g.
thick, free flowing, cloudy,
oily, density, etc.)
Detectable Odour
Yes/No
Oxidiser (Starch Paper)
Yes/No
Flammability
GAS
Colour of cylinder
(state body colour and
colour of any collars)
Yes/No
Markings
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Reference Number:
(please allocate a number to each
container and label)
Dimensions (length x
Please attach Photograph - if unable to do please contact
Veolia who will make arrangements to take pictures
diameter) (cm)
I confirm that the information give above is correct and that the material is not radioactive, not explosive and
not pyrophoric:
Signature:
Print name:
Job Title:
Date:
This form should accompany a formal request for quotation for the disposal of waste.
On completion, email to customerservicescotland@veolia.co.uk or fax to Veolia at
01324.612.019. If you have any queries or require advice contact Veolia customer
services on 01324.632.144.
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