This Drug Enforcement Administration (DEA) questionnaire is used to screen potential non-registrant users of controlled substances. All completed questionnaires must be kept in a secure, confidential file.
The Asbestos awareness document provides information on how to avoid asbestos-containing materials and how to report concerns.
This worksheet is designed to identify risks and develop mitigations associated with biohazards in the laboratory setting.
Periodic building inspections and correction of identified hazards are a proactive part of NCCU's approach to employee, student, and visitor safety. Building Supervisors and Employee Safety Committee members use this form to document monthly building inspections for hazards and safety compliance.
This log provides inventory and tracking required for all controlled substances, from acquisition through disposal.
This record is used to record an initial and biennial (every two years) inventory check of all controlled substances as required by the Drug Enforcement Administration (DEA).
This emergency contact information should be posted in conspicuous locations within each campus building. Please use these numbers to report incidents, accidents or issues to the appropriate group on campus.
This form is completed and posted by room/area exit doors to notify occupants of emergency procedures, equipment available, and how to report incidents, accidents, and near misses that might occur.
This form must be completed and placed on all laboratory equipment prior to removal from the lab for repair/maintenance or for surplus/disposal to verify that all hazards have been removed and the equipment has been decontaminated.
North Carolina Central University provides ergonomic assessment as well as guidance and evaluations to improve the health of its employees and prevent injuries. The use of proper ergonomic measures can eliminate or mitigate the risk of work-related musculoskeletal disorders. To request an ergonomic assessment please complete and submit this request form.
This document contains a Fire and Safety Evacuation Plan template.
A fire watch is a requirement of both the National Fire Protection Association (NFPA) 101 Life Safety Code and the North Carolina Fire Code. The documents in this packet provide all of the required signage and logs for documenting a fire watch in any NCCU building.
Signage is required for fume hoods and biological safety cabinets (BSCs) at NCCU (adhesives sleeves are available from EHS). The signage must include the name and contact information for the person responsible for the equipment.
NCCU is committed to the safe disposal of waste from laboratories, including hazardous chemical and biological waste. Waste types are regulated by local, state and federal regulations. Please refer to this chart for information on handling and disposal of specific types of waste.
Use this form to request pick up of hazardous waste generated on campus.
This form must be completed within 10 days of hire by all employees who will have exposure to blood or other potentially infectious materials as defined in the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. This form allows employees to receive or decline Hepatitis B vaccination.
This permit is to be completed whenever hot work, as defined by NC Fire Code, is being performed on campus. Hot work includes welding, brazing, cutting, soldering, grinding and similar activities. This form must be submitted at least 14 days prior to the planned hot work.
This form serves for the registration of research involving recombinant and synthetic acid molecules and other biological materials by principal investigators and teaching labs with the Institutional Biosafety Committee and Environmental Health and Safety (EHS) department.
The schedule provides information to principal investigators on IBC meeting dates and corresponding IBC application submission deadlines.
This document provides generic chemical safety guideline on the use of isoflurane when administered to research animals and describes basic safety practice for its handling in research labs.
A JHA is a method for identifying and evaluating hazards associated with tasks (steps) with a specific job or activity and eliminating or mitigating them prior to conducting work. A quality JHA can prevent work-related injuries or illnesses by eliminating or controlling identified hazards. It is a means to ensure that workers have the training, equipment and supplies to do their jobs safely. Individuals who perform and supervise the tasks that are being evaluated should participate in the JHA process.
This form is used by new employees to record job-related risks based on exposure to hazardous materials or environments. The completed form is used for safety assessment and kept on file by EHS.
As required by state and federal law, EHS inspects and surveys all campus research groups at least annually. Surveys are comprehensive and use this Laboratory Audit Checklist to address record keeping, fire safety, egress, engineering controls, personal protective equipment, work practices, and where appropriate, chemical and biological safety. NCCU PIs are strongly encouraged to establish a schedule for regular self-inspection using this checklist to complement and prepare for the annual inspection.
This template assists laboratories and teaching labs with generating the required lab door sign to provide emergency responders, Facilities Operation staff and visitors with information regarding potential laboratory hazards, required precautions for entry, and contact information.
This checklist is used by laboratorians to notify relevant campus partners prior to the acquisition of new laboratory equipment to ensure proper information technology (IT), electrical, space and other requirements are considered. A fully executed copy must be submitted with the requisition.
This checklist must be completed by the principal investigator and department chair/designee when exiting and closing laboratories that have contained or where work has been performed with potentially hazardous chemical, biological or radioactive materials, to ensure that the laboratories are left in safe conditions.
The principal investigator uses this template to generate a required Laboratory-Specific Safety Plan for their lab to address the hazards and precautions specific to their laboratory. This plan serves as one half of the required Chemical Hygiene Plan for each lab.
The Laboratory Worker Registration Form is used by EHS to assign safety trainings based on workplace hazards for all faculty, staff, students and visitors working in research labs.
The Lockout Tagout Procedure Form is used when performing a lockout or tagout of energized or other equipment on campus, as required by the NCCU Lockout Tagout Program.
The concern of NCCU for laboratory safety extends not only to NCCU faculty and students but also to any persons visiting laboratories, including minor persons under the age of 18. To encourage STEM in the next generation, we want to ensure that every step is taken to do so in a safe manner that will protect our youngest laboratorians and visitors from common laboratory hazards including biological, chemical, electrical, laser, and physical amongst others. The information in this document provides guidance and requirements for NCCU faculty to mentor high school students in sanctioned training programs.
This record is used to document completion of safety trainings, laboratory orientation and review of required plans and manuals by new laboratorians.
The Principal Investigator (PI) is principally responsible for the safety and environmental health of the lab. This New Research Lab Safety Checklist will help PIs to identify the applicable requirements and provide resources for a safe and efficient move-in to a new location.
Everyone is responsible for identifying and reporting slip, trip and fall hazards. Walk-through inspections of buildings and their surroundings are recommended at least annually using this form. Safety committee members should work with building inspectors to complete and submit copies of the results to EHS and Facilities Operations.
NCCU has a special tax-free alcohol permit, issued by the federal government, which allows scientific departments to purchase tax-free alcohol without paying any federal tax for certain research purposes. Tax-free alcohol refers to ethanol/ethyl alcohol that is 190 proof or higher and regulated by the Alcohol and Tobacco Tax and Trade Bureau (TTB). Laboratories who wish to purchase and utilize tax-free ethanol must designate an alcohol custodian with EHS. To register a laboratory and custodian, submit a written Tax Free-Alcohol Use Request form to [email protected].
This permit form must be completed whenever a tent (>800 sq. ft. [with sides] or >1,800 sq. ft. [without sides]) or membrane structure (>400 sq. ft.) requiring a permit is to be erected on campus. The form must be submitted no less than 30 days prior to the planned installation of the tent or membrane structure.