Surplus Work Order If this surplus equipment contains hazardous materials, Freon, oils, or other substances, please contact the Office of Environmental Health and Safety or follow the instructions in Refrigeration Equipment and Appliance Disposal and do not submit this form. Today's Date * Department Name * OrgID Number * Contact Name * Contact Name First Name First Name Last Name Last Name Contact Phone * Contact Email * Campus Building * Room Brief Description of Property to Be Turned In * Estimated Size of Load * Small (pickup truck)Medium (12' box truck)Large (multiple 12' box trucks)Extra Large (dump truck)Custom (explain in description) Retirement / Transfer (RT) Complete? * Yes No Retirement / Transfer (RT) Number * Special Instructions Any High Value Equipment (current value greater than $1000)? * Yes No If yes, please describe in notes box below. High Value Notes Does the equipment work? Yes No If no, please comment on the condition of equipment in the notes box below. Notes on condition of equipment Does the equipment contain or is it made up of any hazardous material, freon, oils, etc.? * Yes No If yes, contact EHS or follow the instructions "Refrigeration Equipment and Appliance Disposal" and do not submit this form. Submit If you are human, leave this field blank.
