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You are here: Home → OHS → Laboratory Close-Out Notification Form

Laboratory Close-Out Notification Form

last modified 2008-05-01 16:05

1. Responsible Party (Required)

2. Phone (Required)

3. E-mail (Required)

4. Department (Required)

5. Chairperson (Required)

6. E-mail (Required)

7. Primary Contact (Required)

8. Phone (Required)

9. E-Mail (Required)

10. Secondary Contact

11. Phone

12. E-mail

13. Reason for Decommissioning (Required)

14. Old Lab Location (Required)

15. New Lab Location (Required)

16. Preferred Date of Decommissioning (Required)

/ /

17. Please indicate which materials or equipment are applicable to your laboratory (the one you are vacating) (Required)

Biological and Select Agents

Biological Safety Cabinets

Compressed Gas Cylinders

Controlled Substances

Fume Hoods

Hazardous Waste and Chemicals

Radioactive Materials

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