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 completed CHP/Lab Safety Training or Hazard Communication Training? Yes No
   
   Has everyone who will be working with chemicals completed Hazardous Waste Training? Yes No
   
   
3. Will any Homeland Security Chemicals of Interest (COIs) be stored or used?
   Yes No
   
   Have all inventories been submitted to the Environmental Health & Safety Office?
   Yes No
   
   
4. Will Manufactured Nanoparticles (MNPs) be used? Yes No
   
   
5. Will infectious or potentially infectious microorganisms, hazardous biological materials and/or recombinant DNA be used? (Infectious agents are microbial agents which can colonize humans, plants, and/or animals and which may or may not cause disease) Yes No
   
   If used, has everyone who will work with infectious or potentially infectious microorganisms, hazardous biological materials and/or recombinant DNA completed Biological Safety Training?
   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 the applicable registration forms 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 Biological Safety Office (257-1049) immediately for specific requirements.
   
   
6. Will an autoclave be used? Yes No
   
   If used, has everyone that will be utilizing an autoclave completed Autoclave Training?
   Yes No
   
   
7. Will the research involve human gene transfer or vectors for use in human gene transfer? 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 Transfer Registration Form to the Institutional Biosafety Committee? Yes No
   
   
8. 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 completed Bloodborne Pathogens Training? Yes No
   
   
9. 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 completed Radiation Safety Training? Yes No
   
   
10. Will any "dangerous goods" be shipped? Yes No
    
    Has everyone who will be preparing dangerous goods for shipment completed 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.)
    
    
11. 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
    
    
12. 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
    
    
13. 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
    
    
14. Are portable fire extinguishers available for use? Yes No
    
    Has everyone who will be permitted to use a fire extinguisher in an emergency completed Fire Extinguisher Training? Yes No
    
    
15. Will respirators be used? Yes No
    
    Do you have a Respiratory Protection Program? Yes No
    
    Has everyone who will be using a respirator completed Respirator Training?
    Yes No
    
    Has everyone who will be using a respirator had a fit-test and medical evaluation?
    Yes No
    
    
16. Will animals, animal-derived material or biological materials be imported?
    Yes No
    
    Have you received all USDA, CDC and other required permits? Yes No
    
    
17. 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 10.30.2010
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