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Experiment Safety Plan  (also complete - Prior Approval Form)

Appendix XIV (adapted from NMSU Lab Guide - dls )

Lab Location:

 

Date:

 

Title of Experiment

 

 

 

 

Researcher:

 

Office Location:

 

Advisor:

 

 

UNUSUAL HAZARDS

If experiments includes any of the following, give a description, area, size, location, etc. Examples - toxic gases, flammable solvents, flammable gases, high pressure gas or liquid, biological hazard, carcinogen, explosive, radiation generation or radioactive materials.

 

 

 

 

 

 

EMERGENCY SHUTDOWN PROCEDURE

Label all experimental equipment with emergency shutdown information so that a non-operator can easily shut down your equipment.
Is sequence important?

If so, list (below) each step to shut down (in proper sequence).

 

 

 

 

 

 
Device

 

 

 

Shutdown Location

 

 

 

Special First Aid Procedures

 

 

 

 

SAFETY EQUIPMENT & LOCATIONS

EQUIPMENT

nearest location:

equipment in good order?
Fire Extinguisher

 

 
Safety Shower

 

 
Eyewash Station

 

 
Evacuation Alarm

 

 
Exit

 

 

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