Notice of Cleaning and Decontamination Form

Updated 8/10/21

The Notice of Cleaning and/or Decontamination Form (Word) must be completed by a UW employee knowledgeable of the hazardous materials used in, on and/or around a space, equipment, appliance or furniture when either of the following occur:

1. The dirty or contaminated equipment, appliance or furniture is being repaired or removed (for disposal, reuse or surplus).

2. The space is being vacated. 

After following the Guidelines for Cleaning and/or Decontamination, complete the form and tape it to the cleaned and/or decontaminated equipment or surface.