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Injury & Illness Prevention Program Office of Environment, Health & Safety
University of California, Berkeley 2006 LABORATORY SELF-INSPECTION
As part of a Cal/OSHA requirement for an effective Injury and Illness Prevention Program (IIPP) as well as a requirement by the Federal Environmental Protection Agency (EPA), all campus workspaces are required to perform and document self-inspections annually. The attached Laboratory Self-Inspection Form will help document laboratory safety inspections and will assist laboratory researchers in identifying and correcting many common, unsafe practices and conditions. The unsafe practices and conditions identified on this form are prohibited by state laws or campus policies, or are not generally accepted as safe laboratory practices. The procedures for completing this form are as follows: 1. Designate a qualified1 individual to inspect each laboratory using this form, or an equivalent. 2. Send a photocopy of the completed form to your Department Safety Coordinator (DSC). 3. Share the completed form with the Principal Investigator (PI) and other laboratory users. Discuss the findings and corrective actions in a laboratory meeting and encourage others to voice their safety concerns. 4. Correct each identified deficiency as soon as possible and document the correction on the original form. 5. Keep the original form on file in the laboratory for at least one year, so that it will be available to Cal/OSHA, granting agencies, or campus research oversight groups, if requested. 6. If you need assistance correcting conditions identified during the self-inspection or have any questions or concerns about laboratory safety, whether they pertain to this inspection or not, contact your DSC or the Office of Environment, Health & Safety (642-3073).
This form was designed to help ensure compliance with Cal/OSHA, EPA, and other regulations. During some recent Cal/OSHA inspections, laboratories that were able to provide this completed form avoided monetary fines. However, completion of this form and correction of any findings noted herein does not guarantee that these agencies will not issue citations.
EH&S plans to spot check many of the returned forms, comparing notations with actual conditions in the laboratory. Additionally, EH&S will periodically verify that completed self-inspection forms are being kept on file in the laboratory or department. These actions are done to ensure that questions are not misinterpreted and this program remains effective.
Please note: This form does not address specific activities involving research animals, biohazardous agents, lasers, radioactive materials or radiation-producing machines, which have separate and unique inspection requirements that are part of their approval process.
1 1Qualified: The Principal Investigator (PI), laboratory manager, or a person designated by the PI, who by reason of training, experience, or instruction has demonstrated the ability to identify potential hazards. Injury & Illness Prevention Program Office of Environment, Health & Safety
University of California, Berkeley 2006 Laboratory Self-Inspection Form
Please print.
Department: ______Date of Inspection: ______
PI Name: ______Inspector Name: ______
Room and Bldg.: ______Inspector E-mail: ______
Please check the boxes indicating Yes (satisfactory), No (needs correction), or N/A (not applicable).
GENERAL HAZARDS 1. Are aisles, exits, and adjoining hallways maintained free of obstructions that 1 Yes No N/A would hinder emergency access or exiting? Corrective Action: Remove obstructions from aisles, exits, and adjoining hallways. Contact Department Safety Coordinator if help is needed clearing adjoining hallways.
Completion Date: ———————————————————
2. Are there at least 18 inches (47 cm) of vertical clearance between all stored 2 Yes No N/A items and the ceiling-mounted fire sprinklers? (If there are no sprinklers, measure to the ceiling itself.) Corrective Action: Remove stored items that could block sprinklers or contribute to spreading fire to the ceiling.
Completion Date: ———————————————————
3. Are approved sharps waste containers available for disposal of needles, blades, 3 Yes No N/A and other sharps? (Reminder: There should be a proper procedure for disposal of broken glass.) Corrective Action: Purchase a sharps container, if needed. Train all laboratory personnel to avoid bending, cutting, or re-capping syringe needles. The EH&S Fact Sheet “Handling and Disposing of Sharps” is available at www.ehs.berkeley.edu. (Do not put broken glass in the general laboratory trash; put it in a separate and properly labeled container that can be safely disposed of.)
Completion Date: ——————————————————— EMERGENCY EQUIPMENT 4. Are all emergency eyewash and shower stations free of obstructions that would 4 Yes No N/A prevent quick access by someone temporarily blinded by a chemical splash? Corrective Action: Remove all obstructions from emergency eyewashes and showers.
Completion Date: ———————————————————
_IIPP–Form 3-Lab, Rev. 9/22/06 Retain completed form in the laboratory for at least one year. Injury & Illness Prevention Program Office of Environment, Health & Safety
5. Are the emergency eyewashes for the laboratory tested (flushed) monthly and 5 Yes No N/A are the tests documented? Corrective Action: Verify that eyewashes that would be used in an emergency are being flushed monthly, including eyewashes that you rely on but that may be outside of the laboratory (such as in the hallway). Document each test on an attached tag. Contact Physical Plant–Campus Services for plumbing repairs or if safety shower is not being tested annually. Contact EH&S (642-3073) for eyewash tags or if you have questions on testing of emergency eyewashes or showers.
Completion Date: ———————————————————
CHEMICAL STORAGE 6. Are chemical fume hoods kept uncluttered so that air flows properly (e.g., is 6 Yes No N/A storage minimized and are adequate work areas provided)? Can ALL chemical work be done more than six inches into hood? (Note: Chemical fume hood sashes must be in good condition and be used at the proper setting.) Corrective Action: Train laboratory users to minimize hood clutter and place sashes to maintain good airflow and provide splash protection. Contact Physical Plant-Campus Services for repairs. The EH&S Fact Sheet “Fume Hoods” is available at www.ehs.berkeley.edu.
Completion Date: ———————————————————
7. Does the EH&S sticker on the fume hood indicate a hood airflow test within the 7 Yes No N/A last 12 months?
Corrective Action: There should be a red EH&S sticker that indicates the date EH&S checked the airflow and whether the airflow is satisfactory (UCB satisfactory range is generally 100-150 feet per minute). If you are sure the hood is not functioning properly contact your building or facility manager and ask for a service request to fix the fume hood. For further information on proper use of fume hoods, call EH&S at 642-3073 or get our fume hood fact sheet at ehs.berkeley.edu (go to publications).
Completion Date: ———————————————————
8. Are all chemical containers (including squirt bottles and unwanted hazardous 8 Yes No N/A materials containers) clearly labeled with their contents and primary hazard(s) and are they in good condition (not corroded or leaking)? Corrective Action: Label all chemical containers and replace those that are corroded or leaking. Chemical containers must be kept closed when not in use.
Completion Date: ———————————————————
_IIPP–Form 3-Lab, Rev. 9/22/06 Retain completed form in the laboratory for at least one year. Injury & Illness Prevention Program Office of Environment, Health & Safety
9. Are corrosives stored below eye level and are incompatible chemicals stored 9 Yes No N/A appropriately (e.g., acids separate from bases, oxidizers separate from flammables)? Corrective Action: Segregate chemicals by hazard class. Contact EH&S (642-3073) for assistance with chemical segregation or to obtain a copy of the booklet, “Safe Storage of Hazardous Chemicals,” or visit the web site www.ehs.berkeley.edu.
Completion Date: ———————————————————
10. Are containers of hazardous chemicals [1-gallon (4-liters) or larger] stored in 10 Yes No N/A secondary containment to contain a spill? Corrective Action: Provide secondary containment such as chemically-resistant tubs or coated bottles. The container should be equal to or greater in size than the primary container.
Completion Date: ———————————————————
11. Are peroxide formers (such as isopropyl ether and diethyl ether) stored away 11 Yes No N/A from light and heat and labeled with the date they were opened and the expiration date? Corrective Action: Label all peroxide formers with opening and expiration dates. These chemicals may become explosive after prolonged storage. If any of these chemicals are present and have not been used for a long time, do not handle. Contact EH&S (642- 3073) and ask for potentially-explosive-chemical assistance, or visit the web site www.ehs.berkeley.edu/pubs/guidelines/pecguidelines.html.
Completion Date: ———————————————————
LABORATORY EQUIPMENT 12. Look inside each refrigerator and freezer in your laboratory to ensure 12 Yes No N/A flammables are stored in units that are suitable for storage of flammables. Is each refrigerator and freezer in the laboratory labeled as either “safe” or “unsafe” for storage of flammables? Corrective Action: Contact EH&S (642-3073) for assistance in determining if refrigerators are suitable for storage of flammables. The EH&S Fact Sheet “Storing Flammable Liquids in Refrigerators and Freezers” is available at www.ehs.berkeley.edu. Contact EH&S for labels or use an indelible marker.
Completion Date: ———————————————————
13. Look inside each refrigerator and freezer in your laboratory to ensure food is 13 Yes No N/A stored only in units designated “food only.” Are all refrigerators, freezers, and microwave ovens properly labeled either “Food Only” or “No Food or Drink Allowed?” Corrective Action: Label all refrigerators and microwave ovens as “Food Only” or “No Food.” Contact EH&S (642-3073) for labels, or use an indelible marker.
Completion Date: ———————————————————
_IIPP–Form 3-Lab, Rev. 9/22/06 Retain completed form in the laboratory for at least one year. Injury & Illness Prevention Program Office of Environment, Health & Safety
14. Are all compressed gas cylinders adequately secured with non-combustible 14 Yes No N/A restraints to keep the cylinders from falling? (Bench clamps are not adequate to secure large cylinders. Gas cylinders should be capped when not in use.) Corrective Action: Use metal straps or chains. There should be one chain for the upper half and another for the lower half of large cylinders. Contact your department shop or Physical Plant-Campus Services for assistance in installing gas cylinder restraints. In addition, laboratory users should remove the regulator and cap compressed gas cylinders when not in use and return them to the supplier if no longer needed.
Completion Date: ——————————————————— HAZARDOUS CHEMICALS 15. Is there a Chemical Hygiene Plan (CHP) in the laboratory that has been 15 Yes No N/A completed or updated within the last 12 months and have all laboratory personnel reviewed the CHP and documented their understanding by signing the last page? Corrective Action: Contact your Department Safety Coordinator or EH&S if you need a CHP flipchart. Select and assign a Chemical Hygiene Officer for the laboratory and have him/her read, fill out, and follow the guidance in the flipchart. EH&S recommends posting the CHP in the laboratory by the telephone.
Completion Date: ———————————————————
16. Ensure the Personal Protective Equipment (PPE) identified in the Standard Operating 16 Yes No N/A Procedures (SOP) page in the yellow Chemical Hygiene Plan is available to laboratory Additional PPE needed for personnel. Identify additional PPE needs on the right side of this form. this laboratory (quantity) ___safety glasses Corrective Action: Work with your PI or laboratory manager to ensure proper PPE for ___goggles the work done in your laboratory is available including: safety glasses, goggles, face ___face shields shields, protective gloves (chemical, thermal, etc), laboratory coats, aprons, and other PPE ___laser safety eyewear specific to the work done in your laboratory. ___laboratory coats ___aprons Completion Date: ——————————————————— ___other safety equipment (specify)
___gloves for: ___chemical hazards ___thermal hazards ___physical hazards
17. Has the laboratory's chemical inventory been completed or updated within the 17 Yes No N/A last year (or within 30 days of a significant change such as a move to a new location or addition of new chemicals) and submitted to the EH&S Chemical Inventory database, and has a new, colored, hazardous materials door sign been posted at the laboratory entrance? Corrective Action: Update and submit the chemical inventory, and post a new color version of the hazardous materials door sign. Review the EH&S Chemical Inventory Fact Sheet at http://www.ehs.berkeley.edu or contact EH&S (642-3073) with any questions, or for assistance regarding the Chemical Inventory Program or the affiliated Hazardous Materials Door Sign Program.
Completion Date: ———————————————————
_IIPP–Form 3-Lab, Rev. 9/22/06 Retain completed form in the laboratory for at least one year. Injury & Illness Prevention Program Office of Environment, Health & Safety
ELECTRICAL 18. Are extension cords used only as temporary wiring (<30 days) and not 18 Yes No N/A connected in a series (daisy-chained) with other extension cords or power strips? (Cords must be in good condition with no breaks or exposed wiring.) Corrective Action: Dispose of, or repair, all electrical cords that are not in good condition. Remove all daisy-chained and permanent extension cords. Contact Physical Plant-Campus Services for installation of additional outlets where needed.
Completion Date: ———————————————————
19. Is high voltage equipment clearly labeled, properly guarded, and is its use 19 Yes No N/A restricted to trained personnel only? Corrective Action: Label all high voltage equipment (with voltage >600 volts) with appropriate warning. Restrict use of this equipment to properly trained personnel. Retain documentation of the training.
Completion Date: ——————————————————— ERGONOMICS 20. Have ergonomic evaluations been done for laboratory employees who use a 20 Yes No N/A computer for four or more hours per day and for those who have requested an ergonomic evaluation? Corrective Action: Contact your supervisor or Department Safety Coordinator to have a trained ergonomic evaluator assess the computer workstations and document the evaluations. If your department does not have an ergonomic evaluator, contact University Health Services, Ergonomics@Work program (642-8410). Also, laboratory ergonomic information (such as microscope use and pipetting) is available at http://www.uhs.berkeley.edu/Facstaff/Ergonomics/lab/index.shtml
Completion Date: ———————————————————
REMINDER It is recommended that furniture and equipment over four feet tall be bolted to the wall or otherwise secured. Contact your Department Safety Coordinator for assistance with installing seismic restraints. “Q-Brace” seismic restraint guidelines are available on the EH&S web site http:// www.ehs.berkeley.edu/qbrace.html
_IIPP–Form 3-Lab, Rev. 9/22/06 Retain completed form in the laboratory for at least one year. Injury & Illness Prevention Program Office of Environment, Health & Safety
OTHER HAZARDS
List any other hazardous conditions in need of correction that are not covered on this general laboratory self- inspection form. Assign and document correction of each hazardous condition or concern. 1. ______
2. ______
3. ______
OTHER COMMENTS The space provided below can be used to comment on any conditions described in the above questions. ______
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Date______Signature of PI ______
_IIPP–Form 3-Lab, Rev. 9/22/06 Retain completed form in the laboratory for at least one year.