Lab request form

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Lab study request form:

Name and rank: Position: Department:


I. Pre Lab report

Purpose:

Materials:

Method/Procedure:

Hypothesis of result:


II. Safety/Hazard Report

For seen Hazards during lab:

Hazard 1:

Hazard 2:

Hazard X:


General safety rules:

1. Wear eye protection

2. Know location and operation of safety equipment in lab and emergency devices

3. Never work in laboratory alone

4. Do only the experiment approved for the lab

5. Do not wear personal clothing that is not pre-approved for lab use

6. Report all accidents to Lab Master.

7. Do not make oral contact with objects in lab

8. Be mindful of the appearance of strange odors

9. Keep the Laboratory clean. Clean up spills immediately

10. Check lab equipment prior to lab and only use equipment in good condition

11. Check temperature reading on all objects in experiment before reaching. Avoid physical touch of hot objects.

12. Read reagent listings on any known reactions for reagents used in experiment.

13. Clean hands thoroughly prior to leaving lab to avoid oral contamination and optical damage.



III. Authorization Request


Time/shift research is done: Additional Days of study:


Lab requested: Personnel requested:


Estimated Set up time required: Estimated take down time required:


Science team member requesting:


Comments:



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