Light Tube and Ballast Pickup Request Form

Contact Information
Name
Work Unit
Pickup Information

HAVE ALL BOXES AND DRUMS BEEN PROPERLY LABELED?

"Universal Waste Lamps", Building, Start Date
"PCB Ballasts", Building, Start Date
"Non-PCB Ballasts", Building, Start Date

Light Tubes
Enter the number of boxes or drums for each type of light tube.
List any supplies needed to be delivered (empty boxes, drums, etc).