1. Will any of the research be conducted in a laboratory? Yes No
   Does the lab meet minimum UK standards for the intended uses? Yes No
   
   
2. Will chemicals be used? Yes No
   If used in a lab, do you have a Chemical Hygiene Plan (CHP)? Yes No
   If used somewhere other than a lab, do you have a Hazard Communication Program?
   Yes No
   Has everyone who will be working with chemicals attended CHP/lab safety training or hazard communication training? Yes No
   Do you have a copy of the UK Hazardous Waste Manual? Yes No
   Has everyone who will be working with chemicals attended hazardous waste training?
   Yes No
   
   
3. Will Manufactured Nanoparticles (MNPs) be used? Yes No
   
   
4. Will recombinant DNA be used? Yes No
   Do you have a copy of the UK Biosafety Manual? Yes No
   Do you have a copy of the NIH Guidelines? Yes No
   Have you submitted a Recombinant DNA Registration Form to the Institutional Biosafety Committee? Yes No
   
   
5. Will the research involve gene therapy or vectors for use in gene therapy?
   Yes No
   Do you have a copy of the UK Biosafety Manual? Yes No
   Do you have a copy of the NIH Guidelines? Yes No
   Have you submitted a Gene Therapy Registration Form to the Institutional Biosafety Committee? Yes No
   
   
6. Will infectious agents be used (includes human, plant and animal agents and toxins)? Yes No
   Do you have a copy of the UK Biosafety Manual? Yes No
   Have you submitted an Infectious Agent Registration Form to the Institutional Biosafety Committee? Yes No
   Will any HHS Select Agents or USDA High Consequence Livestock Pathogens, Toxins or Plant Pathogens be used, stored, transported, shipped or received? Yes No
   If you answer "Yes" to this item, you must contact the Environmental Management office immediately for specific requirements.
   
   
7. Will human blood, body fluids, or tissues be used (includes human cell/tissue culture)? Yes No
   Do you have an Exposure Control Plan for Bloodborne Pathogens? Yes No
   Has everyone who will be working with human blood, body fluids or tissues attended bloodborne pathogen training? Yes No
   
   
8. Will radioactive materials be used? Yes No
   Do you have a copy of the UK Radiation Safety Manual? Yes No
   Have you submitted the forms for an "Authorization to Possess and Use Radioactive Materials" to the Radiation Safety Committee? Yes No
   Has everyone who will be working with radioactive materials attended radiation safety training? Yes No
   
   
9. Will any "dangerous goods" be shipped? Yes No
   Has everyone who will be preparing dangerous goods for shipment attended training on the U.S. Department of Transportation (DOT) hazardous materials regulations and the International Air Transport Association (IATA) dangerous materials regulations?
   Yes No
   ("Dangerous goods," as defined by U.S. DOT, include explosives, compressed gases, flammable liquids and gases, oxidizers, reactives, poisons, infectious substances, radioactive materials, and corrosive materials.)
   
   
10. Will x-ray producing devices be used? Yes No
    Has the device been registered with the Radiation Safety Office? Yes No
    Do you have a copy of the UK Radiation Safety Manual for Radiation-Producing Devices?
    Yes No
    
    
11. Will Class IIIb or IV lasers be used? Yes No
    Has the device been registered with the Radiation Safety Office? Yes No
    Do you have a copy of the UK Laser Safety Manual? Yes No
    Has everyone who will be working with lasers completed laser safety training?
    Yes No
    
    
12. Will diving (snorkel, SCUBA, hookah, or any other similar diving practice) be involved? Yes No
    Have you submitted a Scientific Diving Project Application to the UK Diving Control Board?
    Yes No
    
    
13. Are portable fire extinguishers available for use? Yes No
    Has everyone who will be permitted to use a fire extinguisher in an emergency attended fire extinguisher training? Yes No
    
    
14. Will respirators be used? Yes No
    Do you have a Respiratory Protection Program? Yes No
    Has everyone who will be using a respirator attended respirator training? Yes No
    Has everyone who will be using a respirator had a fit test and medical evaluation?
    Yes No
    
    
15. Will animals, animal-derived material or biological materials be imported?
    Yes No
    Have you received all USDA, CDC and other required permits? Yes No
    
    
16. Will renovation or new construction be needed in a lab or other work area associated with the research? Yes No
    Have the drawings and plans been submitted to the University Fire Marshal for review and approval? Yes No

I have read and understand the environmental health and safety requirements related to my research project. I have answered the above questions accurately to the best of my knowledge. As principal investigator, I am aware of those areas where I am required to provide lab-specific or project-specific training, and that training has been completed. Everyone who will be working on my research project will receive all of the required training prior to commencing work.

Last Modified 06.01.2006
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