Pick Up Form: Recycled Electrical Equipment

 

Location of Items for Pick-Up and Recycling:

 

Building #____________________________Room #_____________________________

 

 

Description

Manufacturers

Serial #

D.U. Tag #

(if any)

Cost For Pick-Up / Recycling

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Total

Charge To Budget # ______________________________________

 

Approved By ____________________________________________

 

Date __________________________________________________

 


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303.871.2200 (Phone) | 303.871.4818 (Fax) | Privacy Policy | Contact Us | Date Last Revised July 27, 2011

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