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LASER SURVEY FORMS
Appendix XII (adapted from NMSU Lab Guide - dls)

Instrument name: _____________________________________________________________
Manufacturer:      ____________________________________________________________

Laser Class

I  II  III  IV  V

Laser Type:

______________________________

Is instrument designed to be portable?

Yes                       No

 Manufacturer's suggestions for facility safeguards:     Additional facility safeguards deemed necessary:
       
       
       
       
       
Manufacturer's suggestions for safety procedures & PPE:     Additional safety procedures and Personal Protective Equipment (PPE) deemed necessary
Protective eyewear     Training session for all employees Occupational vision program
       
       
       
       

Verification

The safety requirements to protect employees from the potential hazards involved when using lasers have been evaluated, all parties agree on control measures indicated, training is complete, and work can proceed.

_______________________________

_______________________________

Principle Investigator

Environmental, Health & Safety

 

NMSU Laser Database

PI and researchers are requested to provide the following information
on their lasers (via the above link)
and provide updates annually to EH&S (via email)

 

EQUIPMENT IDENTIFICATION

 Laser type: Wavelength  
Manufacturer: Model No: Serial No:
Beam diameter: Beam divergence:
Output power/energy: Pulse duration: Pulse repetion:
Safe eye exposure distance (SEED):
How is laser employed alignment,   scanning,    airborne

PROTECTIVE EYEWEAR IDENTIFICATION

 Protective glasses required: OD of @ Mfr/No  

On hand:

OD of @ Mfr/No *VLT

Other suitable:

OD of @ Mfr/No *VLT
  OD of @ Mfr/No *VLT
Visible light transmission
REMARKS
 
 
SURVEYED BY: DATE:

 

 

EVALUATION

HAZARD CONTROL YES NO
1. Are laser warning signs displayed?
2. Is area secured or have limited access?
3. Is beam termination adequate?
4. Are laser safety glasses available?
5. Are laser safety glasses identified?
6. Standard Operating Procedure in use?
7. Are personnel aware of the laser health hazards?
8. Is viewing of the beam with optical instruments performed?
9. Are precautions for toxic gases, fumes, or projectiles adequate?
10. Others?
11. Training: All potential users must have passed a written examination and understand the safe use of lasers
 
 

 


LASER SAFETY PROCEDURES

___ Appoint a Safety Officer for the lab (well trained).

___ Post Lab Safety Rules for all to see.

___ Label ALL lasers with Classification and Wavelength Information.

___ Wear eye protection (provide glasses at each laser station).

___ Enclose beam path (beam blocks).

___ Reduce beam power level using ND filters during alignment.

___ Use hazard signs (see examples in guide) and lights door interlocks.

___ Place the beam paths at levels below or above the natural standing or sitting positions to avoid inadvertent exposure.

___ Restrict area assess.

___ No fooling around.

___ No liquids or food in the lab area.

___ Post the emergency phone numbers and Procedures for Handling Safety Problems in a conspicuous location.

___ Require all personnel to take a laser safety course and to pass a written and oral exam.

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Lab Safety Guide

Table of Contents

Chapter- 1 2 3 4 5 6 7 8 9 10

Appendices

Appendices