Universal Waste Spill Notification Form
Date of Spill
Time of Spill
Location of Spill
Reported By
Contact Information (Email/Phone)
Type of Universal Waste
Batteries
Lamps
Pesticides
Mercury-Containing Equipment
Aerosol Cans
Other
Approximate Quantity Spilled
Description of Spill (what happened)
Actions Taken (containment, cleanup, reporting)
Personnel Involved/Notified
Additional Comments