APPENDIX 8
ANNUAL LABORATORY SAFETY INSPECTION FORM
Building_______________________________________Room__________ Date____________________
Principal Investigator (PI)_________________________________________________________________
Person conducting inspection:
Inspector signature______________________________________________________________________
|
# |
Description |
Yes |
No |
N/A |
| 1.0 | GENERAL | |||
| 1. Individuals avoid working alone in the laboratory. | ||||
| 2. Appropriate eye protection is worn. | ||||
| 3. Sources of ignition are identified and mitigated prior to working with flammable materials. | ||||
| 4. Food, beverages, or cosmetic products are not used in chemical use or storage areas. | ||||
| 2.0 | HOUSEKEEPING | |||
| 1. Access to emergency equipment (eyewash, shower, extinguishers) and exits are not blocked. | ||||
| 2. All chemical containers are labeled with the name (as listed on the MSDS) and appropriate hazard warnings. | ||||
| 3. Work areas are clean and uncluttered. | ||||
| 4. Chemical wastes are appropriately labeled and logged. | ||||
| 5. Aisles, hallways, and stairs are clean and uncluttered (chemicals are not stored here). | ||||
| 6. Designated areas are clearly marked. | ||||
| 3.0 | SAFETY EQUIPMENT | |||
| 1. Eye wash and safety shower are available if using corrosive or contact hazard materials. | ||||
| 2. Eye wash and safety shower are checked monthly (they should be tagged and initialed when checked). | ||||
| 3. Respirators (if used) are used appropriately (see section 3.3.4). | ||||
| 4. Perchloric acid is handled only in a hood rated for perchloric acid use. | ||||
| 5. Hood vent ducts and fans are inspected annually and cleaned when necessary. | ||||
| 6. Uncluttered hood space is maintained for use. | ||||
| 7. Annual hood airflow test has been performed within the last year. | ||||
| 8. Latest Test Date___________ | ||||
| 9. Researchers know how to use the hoods, and use them appropriately. | ||||
| 4.0 | INFORMATION AND TRAINING | |||
| 1. Laboratory personnel know that medical examinations and or consultations are available under certain circumstances | ||||
| 2. Laboratory personnel understand the hazards of the materials they use (including signs and symptoms of exposure). | ||||
| 3. Laboratory personal are familiar with the Laboratory Standard. | ||||
| 4. Laboratory Personnel are familiar with the Chemical Hygiene Program. | ||||
| 5. Laboratory personnel know where reference materials on the chemicals they use are maintained (including MSDS). | ||||
| 6. Laboratory personnel know the procedures and protective equipment required for each material with which they work. | ||||
| 7. Laboratory personnel understand proper emergency procedures. | ||||
| 8. All laboratory personnel have been trained on the Chemical Hygiene Program and specific safe work practices for their laboratories. | ||||
| 9. The training listed above has been documented in written form. | ||||
| 5.0 | STORAGE | |||
| 1. Flammable liquids above exempt quantities are stored in flammable storage cabinets | ||||
| 2. Corrosives and reactives are not stored above shoulder height. | ||||
| 3. Reactive materials are appropriately segregated. | ||||
| 4. Inimical chemicals are stored and used in designated areas. | ||||
| 5. Ethers and other materials that may form unstable compounds are dated when received and opened. | ||||
| 6. A current inventory of all hazardous materials is available. | ||||
| 7. MSDSs are available for all materials on the chemical inventory. | ||||
| 8. Flammable materials are not stored in unapproved refrigerators. |
ACTION ITEMS:
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Sec. # |
Item # |
Found |
Action |
Completion Date |
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