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Laboratory Inspection Form |
| Building Name:
_______________________________________ Date of Last Inventory on File:____/____/____ Department Name: ___________________________________ Current Symbol: Department Safety Contact: _____________________________________ Room Number(s): _____________________________ Environmental Health and Safety Officer: ________________________________________ Date of Visit: ____/____/____ Biological Agents Used: _______________________________ Room Size: ______________ft2 Radioisotopes: ______________________________________ Tour Members: ____________________________________________________ ____________________________________________________ ____________________________________________________ SECTION 1: OPERATION/GENERAL SAFETY Yes No Responsible for Action Correction Date 1. Are radiation laboratories locked when not in use?
2. Are special, sealable, disposable containers for broken glass provided and pecifically labeled for glass disposal?
3. When pipetting dangerous materials, are squeeze bulbs or mechanical devices used? No pipetting should be done by mouth.
4. Are the correct (rubber, not Tygon) hoses used for Bunsen burners and in good condition?
5. Are only knowledgeable individuals operating autoclaves and centrifuges?
6. Are emergency eye washes, drench hoses and showers unobstructed, inspected, and tagged (showers - yearly; eyewashes - semi-annually)?
7. Have all laboratory personnel practiced using the eyewash station?
8. Are all food and beverage containers and utensils stored and eaten in an area separates from the labs and lab refrigerators?
9. Have all chemical fume hoods passed inspection within the past 12 months?
10. Are chemical fume hoods free from excessive storage which reduces efficiency?
11. Are materials stored in such a way that they are stable and secure against sliding, collapse, falls, or spills?
12. Are storage areas kept free from accumulation of materials that constitute hazards from tripping, fire, explosion, or pest harborage?
13. Is eye protection provided where machines or operations present the hazard of flying objects, glare, liquids, or UV radiation?
14. Are sufficient washing facilities (including eye washes and deluge showers) available for all persons required to handle liquids that may burn, irritate, etc?
15. Are bench tops, shelves, and floors neat, and well-organized with no visible debris?
16. Are all ceiling tiles in place?
17. Is the following PPE (Personal Protective Equipment) routinely used?
SECTION 2: CHEMICAL SAFETY Yes No Responsible for Action Correction Date 1. Are only approved containers used for storage of flammable materials?
2. Are flammable liquids stored in closed containers (no funnels for accumulation)?
3. Are BFD flammable storage guidelines met?
4. Are only approved explosion-proof refrigerators used for cold storage of flammable liquids?
5. Are flammable chemicals stored in a safe manner (notinside cold/warm rooms or covered and refrigerated)?
6. Are incompatible chemicals (i.e. acids and bases; nitric acid/acids; metals and acids) segregated in storage?
7. Are dry ice and cryogenic gases such as liquid nitrogen stored in well ventilated areas (not cold/warm rooms)?
8. Are all highly flammable and toxic procedures performed in a fume hood?
9. Are goggles, face shields, aprons, gloves, and other protective equipment available and used when the nature of the work requires it?
10. Are chemicals stored in a secure manner?
11. Are all chemicals (including waste) stored in well labeled (English chemical name, hazards [e.g.: SULFURIC ACID-CORROSIVE) containers that are in good condition?
12. Are all chemical containers off the floor and window ledges?
13. Is the lab free from excess chemicals in storage?
14. Does the laboratory date peroxide-forming chemicals to ensure that they don't expire?
15. Are incompatible chemicals stored apart (i.e.: in a special area or pin)?
SECTION 3: DISPOSAL OF WASTE CHEMICALS Yes No Responsible for Action Correction Date 1. Are containers labeled properly? Label contents must include all:
2. Are containers properly closed (i.e. no funnels, Parafilm, foil)?
3. Are containers in good condition?
4. Is the hazardous waste compatible with the containers?
5. Are incompatible hazardous wastes separated properly and stored in secondary containment trays?
6. Are containers stored on impervious surfaces (i.e.: free of cracks, gaps, etc.)?
SECTION 4: COMPRESSED GAS CYLINDERS Yes No Responsible for Action Correction Date 1. Are all compressed gas cylinders (whether full or empty) secured to prevent falling? (i.e.: strapped in bracket or holder).
2. Are compressed gas cylinders legibly marked with the name of contents?
3. Are protective caps in place on compressed gas cylinders which are not in use?
4. Do flammable gases (e.g. acetylene, hydrogen) have flash-back arresters?
5. Are gas cylinders ordered only from companies that will accept return of empties?
6. What gases are in use?
SECTION 5: GLASS/SHARPS/BIOHAZARDS Yes No Responsible for Action Correction Date 1. Does the laboratory use sealed, disposable corrugated containers for the disposal of glassware?
2. Does the laboratory use rigid, impervious containers for the disposal of sharps?
3. Are the procedures for the disposal of biological materials known and followed by all laboratory personnel?
4. Is it a standard practice to disinfect biohazard contaminated work areas immediately after each operation?
5. Have you reported to EHS any materials or Recombinant DNA or agents classified as Biosafety Level 2 or higher used in your laboratory?
6. If you have a laminar flow hood or a biological safety cabinet, was it certified within the past year or when its principal use changed?
SECTION 6: ELECTRICAL Yes No Responsible for Action Correction Date 1. Are all new electrical installations and modifications or repairs made by a qualified electrician?
2. Do all electrical appliances have UL approval?
3. Are the cords of all electrical equipment in good condition?
4. Are cords used properly (not run under cabinets) clear of burners, sinks, aisles, etc.?
5. Are circuit breaker panels and cut-off switches located such that they are readily accessible?
6. Are electrical appliances used in wet locations (within 6 feet of water) grounded properly (G.F.C.I.)?
7. Are plug strips used properly (not overloaded)?
SECTION 7: FIRE PREVENTION/SAFETY Yes No Responsible for Action Correction Date 1. Are all fire alarm pull stations unobstructed?
2. Are all exits maintained to provide free and unobstructed exit from all parts of the building?
3. Are all exits free of locks and fastening devices that could prevent free escape (e.g.: wedges, wires, door stoppers)?
4. Are flammable liquid storage cabinets in good condition (closeable, shelves in stable condition)?
5. Are fire extinguishers available where flammable or combustible liquids are stored?
6. Are all laboratory personnel aware of the procedures to be used in a fire or other emergency? (i.e.: A Emergency Response Guide)
8. Are all fire doors closed or on automatic closures? (No door stops)
9. Are sprinklers unobstructed (no combustible storage) within 18" of sprinkler head?
10a. Are all fire extinguishers tagged and dated with current Monthly Quick Checks?
10b. Are all criteria of the extinguisher inspection met?
11. Are all fire extinguishers tagged with appropriate annual inspection?
12. Are their unattended Bunsen Burners in use?
13. Do all fire doors positively latch?
14. Are all aisles and accesses to egress unobstructed?
15. Are all heating baths attended while operating?
16. Are all heating baths equipped with over-temperature shut-off in case the water evaporates?
17. Are electrophoresis operations attended or equipped with automatic shut-off?
18. Are excess combustible materials removed from lab?
SECTION 8: AISLES, EXITS, CORRIDORS, STAIRS, AND FLOORS Yes No Responsible for Action Correction Date 1. Are all floors kept clean and dry and in good repair?
2. Are aisles and passageways clear of all obstructions?
3. Are the lighting levels such that good illumination is provided in all walking, working, and service areas?
4. Are sufficient exits available in case of fire or other emergencies, and are alternate means of escape provided?
5. Are exits marked and readily visible?
6. Is adjacent corridor free from all items?
7. Are stairwell and corridor’s EXIT signs properly illuminated?
SECTION 9: DOCUMENTATION Yes No Responsible for Action Correction Date 1. Does the lab have a:
2. Does the lab maintain a written chemical inventory?
3. Does the lab have access to MSDS's for all chemicals in the lab?
4. Have personnel been trained in:
5. Is the lab door's Emergency Information Placard and hazard classification current (at least within 12 months)?
6. Have you informed Facility operations of any special precautions related to your facility?
Is there any other safety or building maintenance issues in this room? _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________
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Last Modified: May 5, 2004
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