Transfer funds to PI Y N Transfer to another internal source Y N Transfer funds to PI Y N Transfer to another internal source Y N Section 8. Equipment Does the staff member have any equipment which was purchased on grants or via University YES NO funds? If answer is YES, please indicate: Item(s) Current location(s) Who will assume responsibility and what will the management Head of arrangements be for this equipment going forward? Academic Unit to initial to confirm agreement Section 9. Samples, slides, data or other items Does the staff member have any samples, animals, slides, data or other items including YES NO chemical or radiation which need to be handed over before leaving? Please refer to the section above for any equipment emitting ionising radiation, details of which must be provided. In particular, does the staff member have any of the following materials: Genetically modified organisms class 1-3 YES NO Pathogens, Hazard Group (HG)2, HG3, Schedule 5 and SAPO YES NO PHO Schedules 1-6 Licenses YES NO Chemical Weapons YES NO Radioactive Materials (open and closed sources) YES NO Lasers YES NO If answer is YES, to (i) or (ii) above, please indicate: Item(s) Current Who will assume What will the local Please asked Head of *Additional location(s) responsibility for their arrangements be for the any named Academic ongoing storage and ongoing management of individuals Unit to (see documentation? the above? assuming initial to below) responsibility confirm to initial here for their agreement * Additional Authorisation: Details of any samples considered under the Human Tissue Act must be forwarded to Dr Christopher Morris, Newcastle Biobanks Governance Team. Dr Morris will initial the form. Details of items identified in subsection (ii) must be forwarded to the Occupational Health and Safety Service (http://www.ncl.ac.uk/ohss/about/contact.htm) who will initial the form.
Transfer funds to PI Y N Transfer to another internal source Y N Transfer funds to PI Y N Transfer to another internal source Y N Section 8. Equipment Does the staff member have any equipment which was purchased on grants or via University funds? YES NO If answer is YES, please indicate: Item(s) Current location(s) Who will assume responsibility and what will the management arrangements be for this equipment going forward? Head of Academic Unit to initial to confirm agreement Section 9. Samples, slides, data or other items Does the staff member have any samples, animals, slides, data or other items including chemical or radiation which need to be handed over before leaving? Please refer to the section above for any equipment emitting ionising radiation, details of which must be provided. YES NO In particular, does the staff member have any of the following materials: Genetically modified organisms class 1-3 YES NO Pathogens, Hazard Group (HG)2, HG3, Schedule 5 and SAPO YES NO PHO Schedules 1-6 Licenses YES NO Chemical Weapons YES NO Radioactive Materials (open and closed sources) YES NO Lasers YES NO If answer is YES, to (i) or (ii) above, please indicate: Item(s) Current location(s) Who will assume responsibility for their ongoing storage and documentation? What will the local arrangements be for the ongoing management of the above? Please asked any named individuals assuming responsibility to initial here for their agreement Head of Academic Unit to initial to confirm *Additional (see below) * Additional Authorisation: Details of any samples considered under the Human Tissue Act must be forwarded to Dr Christopher Morris, Newcastle Biobanks Governance Team. Dr Morris will initial the form. Details of items identified in subsection (ii) must be forwarded to the Occupational Health and Safety Service (http://www.ncl.ac.uk/ohss/about/contact.htm) who will initial the form.
academic-leaver-checklist-amended-may-2018.docx