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Area Registration Form

Purpose of Registration:

All faculty or manager, referred to as Principal Investigators (PIS) in this document, who currently work in a laboratory/shop.studio are to complete to following form on a yearly basis to :

  1. Keep contact and hazard risk information current
  2. Provide contact and hazard risk information to visitors as well as responders to emergency situations

PI's must ensure that all hazardous chemicals, biological hazards, DEA Controlled Substances, Class IIIB and IV lasers, radioactive materials, radiation producing machines and other equipment under their supervision are properly installed, stored, and inventoried.

PI's must ensure that they have those working in their areas have an understanding of all university policies, procedures, and have completed the training required to ensure a safe workplace.

Registration Procedure:

  1. Complete the form by filling out contact information and choosing :yes" or "no" in the checklist and providing additional information in the spaces provided on the form. If a section does not apply to your areas, check the N/A box and move on to the next section.
  2. Upon Completion of form return to EHS&RM. With the information provided EHS&RM staff will produce signs which will be posted at the entrances of the laboratory/shop/studio.

Contact Information:


Biological:

Do you work with Biological Material?
Do you work with animals/animal parts or tissues?
Do you autoclave microbiological waste (e.g., cultural plates and vials)?
Will you have wate that can't be autoclaved that EHS&RM will need to pick up for disposal?
Do you work with sharps?
Do you work with BSL-1 agents?
Do you work with BSL-2 agents?
Do you work with Recombinant DNA?

Radiation/Laser:

Do you work with Radiation/Laser?
Do you use radioactive substances?
If so, have you worked with radioactive material before?
Do you work with radiation generating machines (X-rays, UV light)?
Do you work with Class IIIB or IV lasers?

Chemicals:

Does this section apply to you?
Does your lab have a current chemical inventory?
Do you hae more than 5 to 10 gallons of flammable chemicals in the lab at one time?
Do yo ugenerate hazardous waste or aqueous wastes w/metals (Cu, Ni, Mo, Zn, Ag, etc)?
Do you have MSDSs/SDSs for ecah of your chemicals?
Does you lab contain carcinogens?
Does you lab contain cryogenic liquids and or solids?
Does your lab contain acids (pH 0-5.5)?
Does you lab contain Hydrofluoric Acid?
Does you lab contain Perchloric Acid?
Does you lab contain Picric Acid?
Does you lab contain Phenol?
Does you lab contain peroxide formers?
Does your lab contain pyrophoric materials?
Does your lab contain oxidizers?
Does your lab contain organic peroxides?
Does your lab contain chemicals that can irritate skin, eyes, and lungs?
Does you lab contain nanomaterials?

Gas Cylinders:

Does this section apply to you?
Do you use gas cylinders?

Safety/Environmental Controls:

Does this section apply to you?
Does you lab contain a biosafety cabinet?
Does your lab contain a fume hood?
Does you lab contain an eyewash?
Does you lab contain a safety shower?
Do you use or will you use respirators?

DEA Controlled Substances:

The Drug Enforcement Agency (DEA) and the Department of Public Safety (DPS) issue controlled substance permits to individual researchers.

Does this section apply to you?
Do you possess DEA controlled substances? If so, do you currently have a license and detailed inventory of usage?
Do you plan on using DEA controlled substances?

Select Agents:

Does this section apply to you?
Will you be working with CDC/HHS/USDA select agents or toxins?

Equipment:

Does this section apply to you?
Does the area have a battery charging area?
Does the area have a centerifuge?
Does the area have equipment under vacuum?
Does the area have an autoclave?
Does the area have a furnace?
Does the area have any etching equipment?
Does the area have a sonicator?
Does the area have any pressure vessels?
Does the area have metal working or fabrication equipment?
Does the area have welding/soldering/brazing equipment?
Does the area have any wood working equipment?
Does the area have any sources generating noise>85 decibles?

Required Personnel Protective Equipment (PPE):

Does this section apply to you?
Safety Glasses/Goggles
Face Shield
Laboratory Gloves (Nitrile, Latex, etc...)
Work Gloves
Particulate Respirator
Respirator
Lab Coat, if speific type must be worm i.e. flame resistant