Academic Shop/Makerspace Space Designation

MOU/Safety Contact Identification

Purpose: The MOU (Memorandum of understanding) form documents the designation of physical space for Academic Shop and Maker-Space work processes. It identifies key personnel and information about the space to ensure safety of occupants. It may be applied when the activities conducted in the space fall under the scope of the Shop Safety Program. It may also be used as an MOU between a Faculty Member (as their approval for space use) and a Student Organization's use of space under their oversight. It also identifies the Shop Manager as the contact person for EH&S and the Shop Safety Committee. This form must be adopted, then updated when operations / personnel / facilities change, or annually for any Student Organization.

For ShLabs (shop/lab) enter your PI/Lab Name.

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Outdoor Space?*

Minor Shop Processes Exempt from the Shop Safety Program:

Many labs / student-use spaces have lower hazard shop processes (e.g. only hand tool, small hand-held power tools only, table-top 3-D plastic printer, etc.) that are ancillary to primary work activities of the space. For such locations, full enrollment in the Shop Safety Program is voluntary. Owners/managers of such spaces must still designate a “safety coordinator” for the Shop Safety Committee (SSC) to communicate with, but may opt-out of sending a representative from the work area to SSC meetings.

Is this space exempt from the shop safety program, based on the above criteria?*
Phone

For Spaces That Are Shops/Makerspaces

Phone
Shop Manager Type*
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For students organizations, please refer to the space agreement with your landlord.

Check all that apply.

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Check all that apply.

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Is shop operated by a student organization?*

Note: Faculty Advisor must complete annually.

Phone

Up to 1 year allowed.

Risk Assessment

Have you submitted a risk assessment previously and nothing's changed? If no, continue the form.

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Next, skip to "For spaces that are shops/makerspaces"

Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

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Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
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Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
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Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
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Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
Caret IconCaret symbol

Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
Caret IconCaret symbol

Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
Caret IconCaret symbol

Select and add all that apply to the functions of the shop. To add type the hazard(s) in and press enter.

Select or enter value
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Type the hazard(s) in and press enter.

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