Information

  • Report Number (Bldg. Abbr.-Room #-Year)

  • Type of Inspection

  • Name of Principal Investigator/Building/Room Number

  • Date of Lab Inspection

  • Lab Inspection Report Prepared by

  • Laboratory Personnel

GENERAL SAFETY

CHEMICAL HYGIENE PLAN

  • Is the Chemical Hygiene Plan accessible in the lab?

  • Has the Plan been reviewed and signed by all lab workers?

  • Is lab-specific safety information in the Plan (Appendix A) being updated annually?

  • Is the lab chemical inventory up-to-date with all Safety Data Sheets available for reference?

REQUIRED SIGNS

  • Are eye protection and other special signs posted on doors (if applicable)?

  • Are there signs on contaminated equipment (if applicable)?

PROHIBITED ITEMS IN LAB

  • Are food and drinks being excluded from the lab?

PERSONAL PROTECTIVE EQUIPMENT

  • Are appropriate safety glasses or googles being worn?

  • Are appropriate gloves being provided?

PHYSICAL SECURITY

  • Are lab doors locked when not in use?

  • Is a list of authorized lab personnel posted near the entrance?

ELECTRICAL

  • Are extension cords being used properly and within limitations?

  • Are Relocatable Power Taps being used properly and within limitations?

  • Are Ground Fault Circuit Interruptors (GFCI) installed within 6 feet of any water source?

  • Are all cords of electrical equipment in good condition?

EMERGENCY PREPAREDNESS

MEANS OF EGRESS AND EXITS

  • Are aisles free of clutter and is there at least 36 inches of clearance?

  • Are exits marked?

EMERGENCY RESPONSE PLANS

  • Is the building evacuation plan posted in a conspicuous location?

  • Are emergency phone numbers near a phone or outside of the door?

  • Have lab personnel been trained on each applicable Emergency Response Plan?

SPILL RESPONSE

  • Is there a spill kit available in the lab with a posted or known location?

CHEMICAL STORAGE

CONTAINERS AND LABELING

  • Are chemical storage containers compatible, appropriate, and in good condition?

  • Are breakables being stored away from shelf edges and at or below eye level?

  • Are chemical storage containers labeled appropriately?

  • Are chemical storage container labels legible?

STORAGE AREAS

  • Are chemicals being segregated and stored with compatible or like chemicals? (i.e. segregation of flammables and oxidizers; nitric acid and acids; acids and bases, etc.)

  • Are storage cabinets and shelves in good condition?

  • Are chemical storage areas identified with signs? (i.e. flammables, corrosives, poisons, etc.)

FLAMMABLE CHEMICALS

  • Are total flammable liquids under the maximum amount allowed per lab?

COMPRESSED GASES

  • Are cylinders stored properly and capped if unused?

  • Are cylinders properly labeled and secured?

  • Are empty cylinders being managed or returned?

PEROXIDE FORMERS

  • Are peroxide forming chemicals being labeled with appropriate dates (received, opened, and 6-month test date)?

REACTIVES

  • Are air, water, light, etc. reactive chemicals stored appropriately?

HAZARDOUS WASTE

  • Is there an identified central location for hazardous waste?

  • Is waste being appropriately segregated?

  • Are proper containers being used (compatible, closable, good condition)?

  • Are hazardous waste container labels legible with required information (name and waste constituents)?

FACILITY STATUS AND LABORATORY EQUIPMENT

HOUSEKEEPING

  • Are floors, walls, work benches, etc. clean?

  • Is the lab neat and clean in appearance?

  • Is there adequate space to perform work safely?

  • Is safety equipment (fire extinguishers, eye wash/shower, etc.) unblocked and accessable?

  • Is there at least 18 inches of clearance from the ceiling in regard to storage?

CHEMICAL FUME HOOD

  • Is fume hood chemical storage appropriate in regard to its designated use?

  • Is the sash placed in the proper condition when not in use?

  • Are lab employees trained in hood use?

SHARPS CONTAINERS

  • Is a proper sharps container in use (if applicable)?

  • Are needles and syringes being stored appropriately (if applicable)?

EQUIPMENT

  • Is all in-use laboratory equipment in good repair?

  • Are all gas and water lines free of leaks and functioning properly?

  • Is all equipment being adequately guarded to prevent injuries?

DEPARTMENTAL ITEMS

RESPONSIBILITIES OF OTHER PERSONNEL*

  • Are eyewash/shower inspections current?

  • Are fire extinguisher inspections current?

  • Are chemical fume hood and biosafety cabinet certifications current?

  • Are chemical fume hoods functioning appropriately?

  • * To be checked by inspection teams. Laboratory personnel should report to the Safety Officer if they notice that these items are not being completed.

  • ADDITIONAL COMMENTS

  • ADDITIONAL MEDIA

  • ADDITIONAL DRAWING

  • INSPECTOR SIGNATURE

  • PI SIGNATURE

  • ADDITIONAL SIGNATURE(S)

  • ADDITIONAL SIGNATURE(S)

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