Appendix M - Sample Prior Approval Form
Appendix M - Sample Prior Approval FormPrior Approval for Highly Hazardous Operations
PI or Supervisor:__________________________ | Location:__________ |
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Name of chemical(s) or operation:__________________________________ |
Each person on this list should have permission from the lab supervisor or Principal Investigator to use the chemicals or conduct the operation above in this lab and have completed the following:
- Are aware of the hazards the chemical(s) or operation(s) pose?
- Has read the Standard Operating Procedures for this process?
- Knows the first aid procedure in case of an exposure?
- Knows what to do in the event of a spill or other emergency?
- Has received any specific training needed above the standard Lab Safety and Chemical Waste Disposal training?
Name | Initials | Date |
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________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |
________________________________ | ______________ | _____________ |