Part IV Summary Checklist of the most common requirements Date: C of F Holder’s Name: Business name: Supervising Address: Chemical Laboratories Signature: City & State: C of F # : Phone #: Exp Date: SECTION A. General Requirement Responses Recommended Action 1. Is there a valid fire permit for the laboratory? Yes If No, discontinue use and remove from site and obtain a permit. Yes 2. Is there a person in your laboratory unit If No, correct and comply. responsible for supervising laboratory who holds a C- 14 C of F as required by code? SECTION B. Laboratory Safety Responses Recommended Action Yes 1. Have you checked if all portable fire If No: correct and comply extinguishers are available, unobstructed and clearly marked? 2. Have you checked whether the owner has Yes If No: correct and comply designated an Impairment Coordinator? Yes 3. Have you checked if all exit ways are free and If No: correct and comply unobstructed? Yes If No: correct and comply 4. Have you checked if the emergency phone numbers and the evacuation plan are updated and clearly posted in appropriate locations? Yes 5. Have you checked if the MSDS sheets are If No: correct and comply maintained correctly and are readily available to lab staff and emergency personnel? Yes If No: correct and comply 6. Have you checked if the electrical cords are in good condition? Yes If No: correct and comply 7. Have you checked if the inspection record is affixed to each hood, and each fume hood is maintained in good working Yes 8. Have you checked if the inspection record is If No: correct and comply affixed to each safety shower and each shower is unobstructed and can work properly? Yes If No: correct and comply 9. Have you checked if neutralizing or absorbing agents are provided at all areas used for the storage of acids? Yes 10. Have you checked if your work areas neat; If No: correct and comply Food/drink absent?
Part IV Summary Checklist of the most common requirements Date: C of F Holder’s Name: Signature: C of F # : Exp Date: Business name: Address: City & State: Phone #: Supervising Chemical Laboratories SECTION A. General Requirement Responses Recommended Action 1. Is there a valid fire permit for the laboratory? Yes If No, discontinue use and remove from site and obtain a permit. 2. Is there a person in your laboratory unit responsible for supervising laboratory who holds a C- 14 C of F as required by code? Yes If No, correct and comply. SECTION B. Laboratory Safety Responses Recommended Action 1. Have you checked if all portable fire extinguishers are available, unobstructed and clearly marked? Yes If No: correct and comply 2. Have you checked whether the owner has designated an Impairment Coordinator? Yes If No: correct and comply 3. Have you checked if all exit ways are free and unobstructed? Yes If No: correct and comply 4. Have you checked if the emergency phone numbers and the evacuation plan are updated and clearly posted in appropriate locations? Yes If No: correct and comply 5. Have you checked if the MSDS sheets are maintained correctly and are readily available to lab staff and emergency personnel? Yes If No: correct and comply 6. Have you checked if the electrical cords are in good condition? Yes If No: correct and comply 7. Have you checked if the inspection record is affixed to each hood, and each fume hood is maintained in good working Yes If No: correct and comply 8. Have you checked if the inspection record is affixed to each safety shower and each shower is unobstructed and can work properly? Yes If No: correct and comply 9. Have you checked if neutralizing or absorbing agents are provided at all areas used for the storage of acids? Yes If No: correct and comply 10. Have you checked if your work areas neat; Food/drink absent? Yes If No: correct and comply