PART 1 - Laboratory Information

  • Laboratory Building and room(s)

  • Location
  • Conducted on

  • Inspector

  • Personnel in lab - enter unoccupied if no personnel are present during the inspection

  • C-14

PART 2 - Laboratory Inspection

Laboratory Signs, Postings, and Documents

  • All required laboratory signs, postings, or document administrative controls are in place?

  • Add media

Chemical Storage

  • Are all laboratory containers stored to properly? i.e.-INCOMPATABLE/UNSTABLE - STORED ON FLOOR - PEROXIDE FORMERS - FLAMMABLE STORAGE LIMIT - CORRODED CONTAINERS/INTEGRITY - UNCAPPED - SPECULATIVE ACCUMULATION

  • Add media

Chemical Labeling

  • Are all laboratory chemical containers sufficiently labeled to perform an exposure assessment and waste determination?

  • Add media

Waste Management

  • Are waste management practices in accordance with the U.S. EPA Resource Conservation and Recovery Act (RCRA), Clean air Act (CAA), or Clean Water Act (CWA)? MAINTAIN SAA - UNLABELED - INCOMPATABLE - UNCAPPED

  • Add media

  • Are regulated medical Waste (RMW)? management practices in accordance with New York State Department of Environmental Conservation (NYSDEC) laws?

  • Add media

Potential for Release to the Environement

  • Are there any containers at risk of fire, explosion, or release to the environment? i.e. - THREATENING DRAIN - STORED NEAR DOMESTIC WATER

  • Add media

Laboratory Health and Safety - General Duty Items and CUNY University Policy

  • Is housekeeping adequate? (i.e Unnecessary accumulation of combustible material, aisle egress, trip hazards, etc)

  • Add media

  • Are all laboratory areas free from food and/or drink?

  • Add media

PART 3 - Facilities Request

  • Please select the type of service requested

  • Please describe below, attaching photos as necessary

  • Add media

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.