Fall 2024 Lab Safety Self Evaluation

To download a blank copy of this survey click here.

This self-evaluation takes approximately 15 minutes to complete. Only complete one self-evaluation per lab. Please email us at ehs-labstaff@austin.utexas.edu if you have any questions about completing this self-evaluation.

NOTE: ALWAYS RIGHT-CLICK WHEN OPENING A LINK. IF YOU DO NOT "OPEN IN A NEW TAB" YOUR FORM ANSWERS MAY BE LOST AND YOU WILL NEED TO RESTART THE SELF-EVALUATION

Respondent Information

Principal Investigator's (PI) First Name

Principal Investigator's (PI) Last Name

PI's EID

PI's Email

Building

Lab Room Numbers(s)

List each lab room with the three letter building code (e.g. NHB 1.780, NHB 3.800, WEL 2.532)

College

Department

Submitter (if different from PI)

Does your lab care about Green Labs/Lab Sustainability?

Yes

Is your lab group interested in becoming a certified Green Lab?

Yes

N/A

Not Sure

Are any personnel working in the lab unpaid (volunteers)?

Yes

Does your lab have cryogens (e.g., liquid nitrogen, liquid helium)?

Yes, <100L (small dewar)

Yes, >100L (large dewar)

Does your lab have cryogenic containers with pressure gauges that you refill on campus?

Yes

Does your lab have nanoparticles?

Yes

Does your lab have any transgenic plants?

Yes

Incident Notification Process

All lab incidents, accidents, and injuries are reported to EHS and your PI and/or supervisor.

Yes

Not Sure

N/A

All lab personnel are aware of the new online Incident Notification system.

Notify us of an incident

Yes

Not Sure

N/A

Hazard Assessment

Lab personnel have conducted risk assessments for experiments.

Injury and Illness Prevention Program

Yes

Not Sure

N/A

Lab personnel have developed written SOPs for chemicals/procedures.

Injury and Illness Prevention Program

Yes

Not Sure

N/A

Safety is discussed at all lab meetings.

Yes

Not Sure

N/A

Lessons learned are reviewed in the laboratory.

Examples can be found on the Lessons Learned EHS webpage.

Yes

Not Sure

N/A

All lab personnel have reviewed the UT Lab Safety Manual.

The UT Lab Safety Manual can be found on the EHS website.

Yes

Not Sure

N/A

Training

All lab personnel have taken Hazard Communication (OH 101), Laboratory Safety (OH 201), Hazardous Waste (OH 202), Fire Extinguisher (FF 205) training and laboratory Safety Refresher (OH 238, every three years).

Lab Training Requirements

Yes

Not Sure

N/A

The Site-Specific Hazard Communication training (OH 102) form has been completed and submitted to EHS for all lab personnel.

The OH102 form can be found on the training section of the EHS website.

Yes

Not Sure

N/A

During Site-Specific Hazard Communication training (OH 102), all lab personnel are trained to call EHS at 512-471-3511 to report all lab incidents, accidents, and injuries.

Yes

Not Sure

N/A

During Site-Specific Hazard Communication training (OH102), all lab personnel are trained on the use and location of the spill kit(s).

Yes

Not Sure

N/A

All lab personnel have taken specialized training for hazards in the area where they work (e.g. Bloodborne Pathogens, Basic Radiological Health, X-Ray Safety, Laser Safety, Biological Safety, Dry Ice Shipping, Compressed Gases, Cryogens).

Yes

Not Sure

N/A

UT HERD

The emergency contact information on lab signs posted by the entrance is current. Request changes through UT HERD by navigating to the "Placards" icon, selecting the lab, and clicking on the "Edit Lab Placard" button.

Yes

Not Sure

N/A

Lab personnel list in UT HERD is current. This information can be found under "Worker Registration" in the "Worker Attached to" table.

Yes

Not Sure

N/A

The chemical inventory in UT HERD has been reviewed and updated this semester. You must document your inventory review using the Chemical Inventory Review Statement in the Chemical Inventory box.

Yes

Not Sure

N/A

All compressed gases are listed in the chemical inventory in UT HERD.

Yes

Not Sure

N/A

The lab-specific biosafety manual has been reviewed within the last year and uploaded into UT HERD. Log in to UT HERD to verify that your uploaded biosafety manual (in SOP Documents) is current and to update the review date.

UT HERD can be accessed via the "Lab Evaluations and UT HERD" section of the EHS website.

Yes

Not Sure

N/A

Lab locations listed in UT HERD are current. Contact EHS to request changes.

Yes

Not Sure

N/A

Personal Protective Equipment (PPE)

The UT Austin Lab Attire Policy has been reviewed by lab personnel.

The Lab Attire Policy can be found on the "Forms and Resources" section of the EHS website.

Yes

Not Sure

N/A

Lab personnel wear appropriate PPE while in the lab. At a minimum, lab personnel should wear a lab coat, gloves, and eye protection while working in the lab.

Yes

Not Sure

N/A

Wearing shorts and open-toed shoes is prohibited in the lab at all times.

Yes

Not Sure

N/A

Flame-resistant lab coats are always worn while handling pyrophorics.

Yes

Not Sure

N/A

Are respirators used in the lab.

Respiratory Protection

Yes

Not Sure

N/A

Lab participates in the Green Labs Kimberly Clark glove recycling program.

If yes, please fill out the glove recycling questionnaire/agreement if you have not already done so. Please note: The program is NOT currently accepting new Labs.

Yes

Not Sure

N/A

If the lab recycles gloves, all lab members are aware that gloves contaminated with hazardous chemicals, hazardous biological materials, and/or radioactive materials cannot be recycled.

General Safety

The hazard information on the lab signs posted by the lab entrance are current. Contact EHS to request changes.

Yes

Not Sure

N/A

Food and drink are prohibited in the lab.

Yes

Not Sure

N/A

Lab personnel know how to access Safety Data Sheets (SDS).

Yes

Not Sure

N/A

Clutter is kept to a minimum in the lab.

Yes

Not Sure

N/A

Usable, unneeded lab consumables, glassware, and field supplies are donated to annual Lab Supply Swaps.

Waste Minimization

Yes

Not Sure

N/A

Lab walkways and work areas are kept free of tripping hazards.

Yes

Not Sure

N/A

Old or unused lab equipment is appropriately deconned before being sent to Surplus or disposed of.

EHS Laboratory Equipment Decontamination. Surplus Property is a program run by Resource Recovery.

Yes

Not Sure

N/A

Access to the lab is controlled when unoccupied (i.e., doors are locked).

Yes

Not Sure

N/A

Appropriate containers are used to transport research materials outside the lab.

Transporting Hazardous Materials. Transporting Biological Specimen.

Yes

Not Sure

N/A

Lab personnel are interested in learning how Green Labs can improve lab sustainability.

Yes

Not Sure

N/A

Chemical Storage

Are any chemicals used in the lab?

Yes

Compressed Gases

Are any compressed gas cylinders used in the lab?

Compressed Gases

Yes

Biosafety

Are any biological materials used in the lab?

Yes

Fume Hoods

Are any fume hoods present in the lab?

Yes

Chemical Waste: Containment, Storage, and Labeling

Containers are closed with appropriate lids unless actively adding waste.

Yes

Not Sure

N/A

Chemical waste that is stored on the floor is in appropriately sized plastic secondary containment.

Note: Secondary containment must not be made of cardboard or styrofoam. If needed, secondary containment options are available for purchase on UT Market.

Yes

Not Sure

N/A

Waste containers are in good condition (i.e., no leaks, spills, incompatible material).

Yes

Not Sure

N/A

All waste is kept at the point of generation (i.e., waste containers are not moved to another room).

Yes

Not Sure

N/A

Lab personnel submit Requests for Disposal (RFDs) regularly so waste does not accumulate in the lab.

Yes

Not Sure

N/A

RFDs are submitted through the online waste system EMS

EMS can be accessed on the "Hazardous Waste Disposal" section of the EHS website.

Yes

Not Sure

N/A

Each waste container has a properly completed waste tag attached to it at all times (i.e., name, phone number, location, chemical constituents, accumulation start date).

Yes

Not Sure

N/A

Special Waste: Sharps, Broken Glass, and Glove Recycling

Are any sharps used in the lab?

Yes

Special Waste: Biological and rDNA Waste

All pathological, microbiological, rDNA, and blood/blood product waste is treated in the lab (e.g., autoclaved) or disposed of through EHS.

Yes

Not Sure

N/A

If waste is autoclaved, an autoclave record is kept in the EHS log book.

Yes

Not Sure

N/A

Equipment Safety

Blast and face shields are used for high pressure or vacuum experiments.

Yes

Not Sure

N/A

All belt driven equipment is protected with belt guards.

Yes

Not Sure

N/A

All fans have guards.

Yes

Not Sure

N/A

Glassware used below or above atmospheric pressure is taped or shielded.

Yes

Not Sure

N/A

Lab equipment is in proper working order and maintained per the manufacturer's instructions.

Yes

Not Sure

N/A

Lab prohibits single-pass cooling/processing water.

Information about sustainable alternatives to single-pass cooling/processing water can be found here.

Yes

Not Sure

N/A

Emergency Equipment

Eyewashes are available and unobstructed.

Yes

Not Sure

N/A

Eyewashes are flushed weekly and documented monthly.

Yes

Not Sure

N/A

Emergency showers and their handles are unobstructed.

Yes

Not Sure

N/A

EHS is notified whenever a fire extinguisher is used.

Yes

Not Sure

N/A

Spill kits specific to the hazards in your lab are available.

Yes

Not Sure

N/A

All lab personnel know the location of the spill kit(s).

Yes

Not Sure

N/A

Electrical Safety

All electrical cords are in good condition (i.e., no cracked/brittle/frayed cords or exposed copper wire).

Yes

Not Sure

N/A

Electrical cords are unmodified as provided by the manufacturer (i.e., ground prong not removed, cords not spliced, etc.).

Yes

Not Sure

N/A

Use of electrical extension cords in the lab is minimized and temporary (<30 days).

Yes

Not Sure

N/A

Lab is free of electrical extension cords and multi-plug power strips running above the ceiling, through doorways, or behind walls.

Yes

Not Sure

N/A

Lab is free of unsecured and unprotected electrical extension cords and multi-plug power strips running across the floor where they pose a tripping hazard.

Yes

Not Sure

N/A

Lab is free of electrical extension cords and multi-plug power strips connected in series (daisy chaining).

Yes

Not Sure

N/A

Electrical panels/disconnects are unobstructed. Panel doors are closed.

Yes

Not Sure

N/A

Electrical panel and wiring modifications are only performed by a licensed electrician.

Yes

Not Sure

N/A

For research experiments, all grounding equipment and electrical noise reducers are UL listed.

Yes

Not Sure

N/A

Equipment plugged into multi-plug power strips is within the capacity of the circuit being used.

Yes

Not Sure

N/A

Lab personnel are prohibited from resetting breakers. Facilities Services is called instead.

Yes

Not Sure

N/A

Fire/Life Safety

All exits are unobstructed and all walkways in the lab have 36 inches of aisle clearance.

Yes

Not Sure

N/A

Areas adjacent to all exits are free of hazardous chemicals and compressed gas cylinders (i.e., hazard-free emergency egress).

Yes

Not Sure

N/A

Lab doors are kept closed to provide a fire and smoke barrier.

Note: Doors are prohibited from being propped open.

Yes

Not Sure

N/A

Hallways are free of hazardous materials used by the lab.

Yes

Not Sure

N/A

Shipping

Does your lab ever ship any research materials?

eShip Global EHS Hazardous Shipping

Yes

DEA Controlled Substances

My lab possesses DEA controlled substances.

A list of DEA controlled substances can be found on the DEA's website.

Yes

Not Sure

N/A

The Controlled Substances Self-Evaluation form has been completed and submitted to EHS this year.

The Controlled Substances Self-Evaluation form can be accessed on the "Forms and Resources" section of the EHS website.

Yes

Not Sure

N/A

Expired controlled substances are disposed of within 90 days of expiration.

Yes

Not Sure

N/A

Controlled substances older than 3 years have been disposed of (even if no expiration date).

Yes

Not Sure

N/A

Describe any other safety concerns.

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