Laboratory Safety
Laboratory Safety
Laboratory Safety
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Date<br />
Lab Information<br />
Department<br />
Principal investigator (PI)<br />
PI telephone number<br />
PI email address<br />
Building<br />
Lab room numbers<br />
Lab contact person<br />
Lab contact telephone number<br />
Lab contact email address<br />
Lab phone number<br />
Inspection Information<br />
Inspector<br />
Inspector email address<br />
Accompanied by<br />
<strong>Laboratory</strong> <strong>Safety</strong><br />
Category A Chemical Hazard Inspection Checklist<br />
501 Westwood Plaza, 4 th Floor • Los Angeles, CA 90095<br />
Phone: 310-825-5689 • Fax: 310-825-7076 • www.ehs.ucla.edu<br />
Explanation of Ratings<br />
1: Compliant • 0: Non-compliant/not acceptable • N/A: Not applicable • *Denotes Administrative Deficiency<br />
S: Serious Finding that must be corrected within 48 hours or less, depending on severity of finding<br />
Revised 11/2012 -1- <strong>Laboratory</strong> Inspection Checklist
Working with Category A Chemicals<br />
1 0 S N/A Inspected Comments<br />
Category A chemical(s) present in lab<br />
Category A chemicals stored properly<br />
Appropriate PPE available<br />
Emergency and <strong>Safety</strong> Equipment<br />
Lab personnel have completed PPE training<br />
Personnel who use Category A chemicals are<br />
properly trained<br />
Pertinent SOP’s available for using Category<br />
A chemicals<br />
SDS available for all Category A chemicals<br />
(either hard or electronic copies*)<br />
SDS location known to each employee*<br />
Category A chemical(s) recorded in chemical<br />
inventory<br />
Explanation of Ratings<br />
1: Compliant • 0: Non-compliant/not acceptable • N/A: Not applicable • *Denotes Administrative Deficiency<br />
S: Serious Finding that must be corrected within 48 hours or less, depending on severity of finding<br />
Air or Water Reactive Chemical(s)<br />
Potentially Explosive Chemical(s)<br />
Acute toxin(s)<br />
1 0 S N/A Inspected Comments<br />
Fire extinguisher present/charged/accessible<br />
(area around fire extinguisher clear)<br />
Fire extinguisher inspected monthly Date:<br />
Approved emergency eyewash and shower<br />
present and accessible within 10 seconds<br />
Emergency shower/eyewash inspected<br />
monthly<br />
Clearance area around shower at least 16” in<br />
each direction/eyewash accessible<br />
First-aid kit present, stocked, and without<br />
expired products<br />
Chemical spill material or kit available and<br />
spill procedures known to personnel<br />
Date(s):<br />
Revised 11/2012 -2- <strong>Laboratory</strong> Inspection Checklist
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