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Dangerous Goods Shipment Form

NOTE: The notification of dangerous goods shipment form must be submitted to EHS for each package you ship. It is also required that personnel who package dangerous goods for shipment receive training. This is a Temple University requirement and is also mandated by Federal and International laws. The Environmental Health and Safety Department provides this training free of charge for Temple employees. If you have any questions on this form or need training information please contact EHS.

Contact Information

Shipper's Name:

Shipper's Department:

Phone Number:

Emergency Contact:

Emergency Phone Number:

Package Contents

Dangerous Goods
Type(s):

Quantity:

Type of
Packing:
Line 1
Line 2
Line 3
Line 4

Shipping Information

Shipping Date

Shipping Vendor's Name:

Where's this Package Going?

Shipping Address (Line 1):

Shipping Address (Line 2):

Shipping Address (Line 3):

Package Tracking #:
(If available)

Comment: