Information

  • Document No.

  • Building

  • Room number

  • Principle Investigator

  • Principle Investigator Present?

  • Other faculty/staff present:

  • Department

  • Conducted on

  • Prepared by:

Door Placards

  • Is a door placard posted?

  • Is the door placard accurate and up to date?

Chemical Labeling, Storage & Transport

  • Containers are clearly labeled

  • Containers are compatible with the chemical (e.g. No food containers)

  • Containers are kept closed.

  • Labeled chemical cabinets are true to their contents.<br>

  • Heavy containers are stored on lower shelves

  • Chemicals of different hazard classes are segregated to avoid incompatible chemical and conditions (e.g. flammable liquids and oxidizers, corrosives and metal containers/cabinets, oxidizing acids and organic acids.)

  • Corrosives are not stored above eye level

  • Refrigeration units containing flammables are approved for flammables storage

  • If pyrophorics or air/water reactive solids are present, proper PPE, firefighting measures, administrative, and engineering controls are in proper use

  • Materials with short shelf lives are dated and disposed of per supplier's recommendations

  • Refrigeration units and/or microwaves for chemical storage and processing are labeled "Not for Food"

Hazardous Waste Management

  • Containers are compatible with waste

  • Containers are kept closed except during transfer of materials

  • Containers are labeled with the official UT Hazardous Waste label

  • Constituents are described with complete chemical name

  • Hazardous waste storage area is labeled with yellow Hazardous Waste Storage Area sign

Fume Hood

  • Each chemical fume hood has been surveyed for proper airflow

  • Fume hood vents are unobstructed

  • Fume hood is not overloaded (e.g. Large equipment or excessive storage).

  • Sash glass is clean and maintained to have a clear visual path to work being done

Compressed Gases

  • Storage quantities are minimized

  • Cylinders are secured from tipping by a chain or strap

  • Protective valve caps are in place

  • All cylinders including lecture bottles, if present, are stored upright

  • Does safety manifold have a restrictive orifice and a pressure relief valve?

Equipment & Physical Hazards

  • Flexible cords and other electrical equipment are in good condition

  • All electrical equipment is being used according to its design and approved use (e.g. Circuits are not overloaded. Power strips are not daisy-chained. Extension cords are not running through ceiling tiles, behind heavy movable objects or through walls.)

  • Circuit breaker panels are unobstructed

  • Machines, instruments and tools have access panels/guards are in place

General Work Environment

  • Is the space organized and free from clutter or potentially unsafe working conditions?

  • Current storage conditions do not present a fire hazard and do not block sprinkler systems

  • Fire extinguisher is mounted on the wall and access is not blocked by equipment or supplies

  • Emergency eyewash and shower are accessible

  • Aisles are uncluttered and are without tripping hazards

  • All exits are unobstructed

  • Is the area free from any other recognized hazards?

Personal Protective Equipment (PPE)

  • Appropriate equipment (such as gloves, safety glasses, goggles) is available and in functional condition<br>

  • PPE is being worn correctly in the laboratory (check N/A if no work is being performed at time of inspection)

  • PPE is being stored properly to guard against contamination or damage

  • Are respirators used? (Not scored)

  • Are respirators used as part of a respiratory protection program? (Not scored)

  • Is hearing protection used? (Not scored)

  • Is a hearing protection used as part of a hearing conservation program? (Not scored)

Personnel Knowledge and Practices

  • Do lab personnel know what to do in the event of an emergency, such as fire, injury, including evacuation routes?

  • Do lab personnel know the location of and how to use emergency equipment, such as safety showers and eyewash stations?

  • Emergency eyewash stations are tested weekly to ensure operation by lab personnel

  • Secondary containers and carts when necessary are used during transport of more than one liter of chemicals or for particularly hazardous chemicals

  • Do lab personnel know how to clean up chemical spills and when to seek help?

  • Fume hoods are used with the sash in appropriate position

  • Cylinder carts are used for transport

  • Empty or unused gas cylinders are promptly returned to supplier

  • A written Chemical Hygiene Plan is available in the laboratory

  • Do lab personnel know who the Chemical Hygiene Officer for the lab is?

  • Do lab personnel know what an MSDS or SDS is and where to find them and other safety information?

  • Has the lab submitted to EHS a current chemical inventory in the last calendar year?

  • Lab check-out procedures for departing lab workers are in place to avoid long-term storage of abandoned chemicals

Training

  • Documentation of general lab safety training is available

  • Documentation of Hazard Communication (HazCom) with GHS training is available

  • All personnel who generate or handle hazardous waste have had hazardous waste training

  • Personnel have been trained and PPE Training Certification Forms are available for review (not scored)

  • Documentation of lab-specific training on SOPs is available (not scored)

Potential improvements or General Comments

  • Item #1:

  • Item #2:

  • Item #3:

  • Item #4:

  • Item #5:

Web Links

  • EHS Web Page

    http://www.ehs.utk.edu

  • EHS Safety Manual

    http://ehs.utk.edu/safety%20manual/Safetymanual2kj.html

  • Lab Safety Manual and Chemical Hygiene Plan Template

Safety Office Representative Performing Inspection

  • Environmental Health & Safety Representative:

  • Signature

Responsible Laboratory Representative (PI or designee)

  • I am aware that this Laboratory Safety Survey has been conducted and will participate in addressing corrective actions as appropriate to my position and level of authority.

  • Laboratory Representative

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.