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When completing this request form, please specify the maximum quantity of each chemical that you would like. 

Click here to see the current list of surplus chemicals available.

You can cut chemical names from the surplus chemical list and paste into the Chemicals Wanted text box below.

If you have any chemicals that you would like to donate to the surplus chemical recycling program, then please send an email to Brenda Coolbaugh.

Surplus Chemical Request Form

Your Name:
Department:
Building:
Room:
Work Phone:
E-mail:
Chemicals Wanted :


All requests are sent to John H Terry