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Environmental Health & Safety Forms
Forms and Required Permits
EH&S Forms | MacroTechnology Forms | Radiation Safety Forms
| Form Name | Description | Format |
|---|---|---|
Environmental Health & Safety | ||
| Accident/Near Miss/Quality Improvement Reports | This form is to be filled out anytime there is an accident (vehicle, injury or property loss) or near miss (potential for accident) involving ASU facilities or property whether or not a claim is filed. | |
| Bloodborne Pathogens | This form is to be filled out for any person working with blood, human fluids or tissues who does NOT want Hepatitis B vaccine. After signing it should be filed with the PI or supervisor along with the training record. | |
| Confined Space Entry - Except MacroTechnology Works | A permit is required to enter a confined space that may have a hazardous atmosphere or contains recognized serious safety or health hazard. See ASU’s Confined Space Entry Plan for more information. | |
| Fire Safety Events Permit Application | An Events Permit Application must be filled out and submitted to ASU EH&S/Fire Marshal two weeks prior to the event. For more information see Special events Compliance Guidelines. | |
| Fire Safety Self Inspection | ||
| Indoor Air Quality (IAQ) | This form is to be used if you have concers about indoor air quality at ASU. | |
| Indoor Air Quality - Asbestos | This form is to be used to request removal , repair, encapsulation, testing or evaluation for known or suspected asbestos contamination. | |
| Laboratory Safety Chemical Inventory Template Prior Approval Form Responsible Party Information Sheet | These templates are provided to keep track of the chemicals currently in the laboratory. Before obtaining a New Hazardous Chemical a prior approval form must be filed with EH&S. The Responsible Party Information Form is for lab registration. | |
| Personal Protective Equipment (PPE) Certificate of Hazard Assessment Training Verification | All managers and supervisors must survey the work areas and activities under their control to determine where PPE may be required. | |
| Personal Protective Equipment (PPE) Chemical Resistant Gloves | These guides can be used to help determine the manufacturer and model of glove that will provide adequate skin contact protection during chemical use. | |
| Personal Protective Equipment (PPE) University Services Respirator Evaluation Instructions Non-University Services Respirator Evaluation Instructions | Respirator Evaluation Instructions for University Services and non-University Services personnel. | |
MacroTechnology Works | ||
| Chemical Approval | This procedure defines the process for requesting an approval for use of new chemical materials at ASU’s MacroTechnology Works | PDF - Process PDF - Form |
| Chemical Handling and Personal Protective Equipment - Safety Glasses | This is the procedure for obtaining perscription safety glasses at ASU as described in FDC Chemical Handling and Personal Protective Equipment. | |
| Chemical Inventory | ASU MTW maintains on-site chemical inventories below the Screening Threshold Quantities (STQ) for all chemicals listed in DHS - COI Appendix A | |
| Security Access | This is to request access to ASU MacroTechnology Works | |
| Confined Space Entry Permit - MTW | MacroTechnology Works has a separate Confined Space Entry Procedure. | |
| Hazard Communication | The MTW Hazard Communication Checklist is to be used to make sure the Hazard Communication Standard is followed. | |
Non Emergency Incident | An incident that arises that does not constitute an emergency but additional assistance is necessary, e.g.an odor in the work area. | |
| Laser Registration | Lasers must be registered within 30 days of arrival on campus whether or not they are used. | |
| Laser Control Area | This permit is necessary for anyone working at or visiting ASU who procures or uses Class IIIb or IV lasers. | |
| Laser Safety Training | This class is for anyone working at or visiting ASU who uses Class IIIb or IV lasers. Prior to taking this class the user must have a base line eye exam. | |
| Radio Active Material Sub- License Application | The use of radioactive materials at ASU requires an appropriate sub-license or permit issued by the Radiation Safety Office. | |
| Radioactive Material (RAM) Training | This class is required for people working at or visiting ASU who procure, use or dispose of radioactive materials. | |
| Source Utilization | Use this form to keep track of use of radioactive chemicals. | |
| Radiation Producing Equipment (RPE) License | An RPE license must be obtained before registering any RPE material or equipment. | |
| Analytical X-Ray | This form may be used for registering any type of regulated radiation producing equipment. | |
| Radiation Producing Equipment (RPE) Training return to top | This class is required for people who want to procure, or need access to ionizing radiation producing equipment | |
