Title Page

  • Location of Monitoring

  • MD1

  • MD4

  • MD6

  • MD11

  • Personnel

  • Conducted on

Checklist

Area of Monitoring

  • Work area

Common Area

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • Unassigned space is not occupied

  • No major changes to placement of user's equipment (e.g. new/movement of equipment)

  • No mishandling or inappropriate storage of laboratory items (e.g. samples or chemicals)

  • Others

Gas Detection System

  • Alarm/fault indicator not lighted up

  • Gas cylinders properly secured

  • Others

Cold Room

  • Monthly cleaning is carried out and recorded

  • Room is kept clear of litter, spill, carton boxes, liquid nitrogen and compressed gas tanks

  • Aisle and doorway are free of obstructions and permits visibility and movement

  • Lights in good working order

  • Mop and floor wipes accounted for

  • Control panel status (temperature readings ok, refrigerant systems switched on, no fault lights/alarms)

  • Others

Dark Room

  • Fixer, developer and wash chambers in film processor in good condition

  • Fixer and developer in chemical mixing tanks in good condition (level and color)

  • EPAN chamber in good condition (no overflow)

  • Drain pipe flow in good condition (free of kinks and no detachments)

  • Water filter in good condition

  • At least 1 set of fixer and developer stored in dark room

  • Lights in good working order (normal and film-sensitive lights)

  • Usage log book checked and verified

  • Room is clean and kept clear of litter/leak

  • Doorway is free of obstructions and permits visibility and movement

  • Empty fixer and developer bottles removed

  • Others

Freezer Room

  • Temperature is adequate

  • Lights in good working order

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • Others

Equipment

  • Glasswasher chamber condition/cleanliness

  • Autoclave chamber condition/cleanliness

  • Autoclave blue gasket is fitted properly

  • Autoclave usage log sheet is sufficient

  • Pressure reading gauge zero (when temperature is below 100°C)

  • No misuse of autoclave (e.g. spill, cross usage of waste and clean autoclaving without official labeling)

  • Corrosive and flammable safety cabinets in good condition (no rust/corrosion)

  • Vent openings of flammable safety cabinets are sealed with bungs supplied with the cabinet or with bungs specified by the cabinet manufacturer

  • No items resting on base plate of drying oven

  • No inappropriate usage of drying oven (as incubator/storage of unclean items)

  • Temperature reading of drying oven is below 100°C

  • Fume hood airflow is present

  • Fume hood sash down when not in use

  • No error messages/alarms/malfunctions on equipment control panel

  • Ladder properly secured and accounted for

  • Emergency shower test kit accounted for

  • Equipment parts and accessories accounted for

  • Others

Emergency Response Equipment

  • Emergency eyewash and shower checked and recorded accordingly

  • Access to emergency response equipment is clear of obstruction

  • Fire extinguishers are accessible and free of obstruction

  • Firemen access point are not obstructed

  • Spill kits are checked and recorded accordingly

Electrical Safety

  • Electrical plugs are labelled with amperage

  • Extension cords are affixed with "Safety Mark" logo or equivalent

  • Extension cords are used appropriately (Note: e.g. not used where permanent wiring should be installed, no universal socket on extension cord, not used in chemical store/fume hood/cold room)

  • Universal travel adapters are affixed with "Safety Mark" logo or equivalent

  • Power supply for equipment plugged into socket via universal travel adapter is switched off or disconnected when the equipment is left unattended

  • Multi-plug adapters are not used

Others

  • Rooms are used for their designated purpose. (Note: Change of use includes store room to office, laboratory to store room, etc.)

Common Area

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • Unassigned space is not occupied

  • No major changes to placement of user's equipment (e.g. new/movement of equipment)

  • No storage of suspicious laboratory items

  • Others

RO Plant Room

  • Room is clean and kept clear of litter/leaks

  • No error messages/alarms/warning lights on system control panel

  • Pre-filter in good condition

  • Reserve tank level is sufficient

  • Booster pump pressure reading within normal range

  • PUB water tank level is sufficient

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • Others

Emergency Response Equipment

  • Access to emergency response equipment is clear of obstruction

  • Fire extinguishers are accessible and free of obstruction

  • Firemen access point are not obstructed

  • Others

Electrical Safety

  • Extension cords are affixed with "Safety Mark" logo or equivalent

  • Universal travel adapters are affixed with "Safety Mark" logo or equivalent

Others

  • Rooms are used for their designated purpose. (Note: Change of use includes store room to office, laboratory to store room, etc.)

Common Area

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • No storage of suspicious laboratory items

  • Others

RO Plant Room

  • Room is clean and kept clear of litter/leaks

  • No error messages/alarms/warning lights on system control panel

  • Pre-filter in good condition

  • Reserve tank level is sufficient

  • Booster pump pressure reading within normal range

  • PUB water tank level is sufficient

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • Others

Vacuum/Compressed Air Plant Room

  • Aisles and doorways are free of obstructions and permits visibility and movement

  • No error messages/alarms/warning lights on system control panel

Emergency Response Equipment

  • Access to emergency response equipment is clear of obstruction

  • Fire extinguishers are accessible and free of obstruction

  • Firemen access point are not obstructed

  • Others

Completion

  • Additional recommendation

  • Attachment (if any)

  • Full Name & Signature of Personnel

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.