ALFRED UNIVERSITY SURVEY FOR REMOVAL OF USED COMPUTER and OTHER ELECTRONIC EQUIPMENT or INSTRUMENTS, NON-ALKALINE BATTERIES and SCRAP METAL Semester: Spring / Fall Year: (Circle one) Please search out all unwanted used electronic equipment or instruments that would qualify for recycling based on the Disposal of Used Computer Equipment and Other Used Electronics Policy. Office equipment, nonalkaline batteries and scrap metal will also be accepted for recycling. Chairperson, Supervisor or designee should coordinate department survey efforts to eliminate duplicate submissions. Submit completed form to Dean Perry no later than 1 day prior to the announced collection date at perrydr@alfred.edu or Myers Hall, Room 117. Note: Please attach a label on equipment and/or boxes with the following information: Division Name and the words “For Electronic Recycling” Specific Location of stored material for pick-up __________________________ Name/Division _________________________ Building ___________________ Number of units: Monitors (CRT) ____________ approx. size ___x___x____ Separate Disc Drives _______ Monitors (CRT) ____________ approx. size ____x___x___ Keyboards ______ Mouse (s) _____ Computer processing units _______________ approx. size ____x___x____ Computer processing units _______________ approx. size ____x___x___ PLEASE BOX CABLES, BATTERIES AND SMALL ELECTRONICS. Other equipment: (scrap metal, batteries, printers, fax machines, TVs, VCRs, PC Boards, UPSs, cables, laboratory instruments, etc.) What is it _____________ how many _________ approx. size __x___x__ What is it_ _____________ how many _________ approx. size __x___x__ What is it ______________ how many _________ approx. size __x___x___ What is it______________ how many __________ approx. size __x___x____ Name of person submitting this survey____________ phone #___ ____ Dean Perry EH&S Technician Hazardous Waste Coordinator Office: x3020 perrydr@alfred.edu Fax: x2086