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Home , Abrin, Chlorine trifluoride, Germanium tetrafluoride, Oxygen difluoride, Perchloryl fluoride

Name: Dept: Date:

2018 Annual Survey of Biological and Chemical Agents regulated by Homeland Security (and carcinogens regulated by OSHA)

Due (date)

All labs that do not have a current chemical inventory in Chematix MUST complete this survey. The University is required to make an annual report of all chemicals on the Chemical Facility Anti-Terrorism Standards (CFATS) lists. Additional information regarding the regulations is available on the EH&S website at http://www.safety.rochester.edu/restricted/occsafe/chemicalagent.html and https://www.selectagents.gov. 1. Please review the lists on the following pages and indicate if any are possessed by your lab. The CAS# has been added to the list for ease of searching databases. The CAS# is a Chemical Abstract Service numbering system which assigns a unique number to every chemical substance based on structure; this helps avoid confusion by use of synonyms or different naming conventions. a. If yes for possession, place an X in the applicable box and if requested, include the quantity held in your lab. b. If no, leave blank. 2. After reviewing the list, please complete the information box below (or on last page for possession), then sign, date and return to EH&S. 3. Please call Donna Douglass at 275-2402 if you have any questions. Thank you for your cooperation in collecting data required by the Department of Homeland Security!

Possession: 1) Fill in applicable boxes, 2) have PI sign last page, 3) return all pages to Donna Douglass

OR

Non-possession: 1) Check only one box on the left, 2) sign, 3) return just this page to Donna Douglass I do not have a lab, do not work in a lab, nor do I possess any of the agents in this survey.

I work in a lab for a Principal Investigator (i.e. they will be completing this survey for our lab).

Principal Investigator: ______

I have my own laboratory. We do not possess any of the agents in this survey. I have done a diligent search of the laboratory space under my possession, custody or control. I have verified that none of the agents in this survey are in my or my employee’s possession, custody or control at the UofR.

Name (print): Department:

Building: Lab room numbers:

Print Name (if not already done) Signature Date Name: Date:

1. Carcinogens (regulated by OSHA) 2. Maximum Nucleic Yes CAS# Quantity * (X) (x) of Toxin (x) 1,2-dibromo-3-chloropropane 96-12-8 1,3-Butadiene 106-99-0 Botulinum 2-Acetylaminofluorene 53-96-3 (short, para- 3,3'-Dichlorobenzidine (and lytic alpha) 91-91-1 its salts) Diacetoxyscirpenol 4-Aminodiphenyl 92-67-1 4-Dimethylaminoazobenzene 60-11-7 4-Nitrobiphenyl 92-93-3 Staphylococcal entero- toxins A, B, C, D, E Acrylonitrile 107-13-1 subtypes Alpha-Naphthylamine 134-32-7 T-2 toxin Arsenic, inorganic 7440-38-2 1332-21-4 *Nucleic , synthetic or naturally derived, that encode for the functional form(s) of the toxin Benzene 71-43-2 Benzidine 92-87-5 3. Chemical Facility Anti-Terrorism Standards Beryllium 7440-41-7 (CFATS) Chemicals beta-Naphthylamine 91-59-8 Quantity Most common at UofR CAS# Yes beta-Propiolactone 57-57-8 (X) (in pounds) bis-Chloromethyl ether 542-88-1 Aluminum metal - Cadmium 7440-43-9 powdered metal 7429-90-5 form, no salts Chromium (VI) Compounds 1333-82-0 Hydrogen Peroxide 7722-84-1 Ethyleneimine 151-56-4 > 35% v/v Magnesium metal - Ethylene 75-21-8 powdered metal 7439-95-4 Formaldehyde/formalin (not 50-00-0 form, no salts in kits) Nitric acid 7697-37-2 Methyl chloromethyl ether 107-30-2 Triethanolamine 102-71-6 Methylene (dichloro- (liquid) 75-09-2 methane) Triethanolamine Methylenedianiline 101-77-9 hydrochloride 637-39-8 (solid) N-Nitrosodimethylamine 62-75-9 Vinyl chloride 75-01-4 To convert the above commonly used chemicals from liters to pounds:  Hydrogen peroxide: 1 liter = 2.43 pounds

 Nitric acid (conc): 1 liter = 3.10 pounds  Triethanolamine: 1 liter = 2.46 pounds

2018 Annual Survey of Biological and Chemical Agents regulated by Homeland Security Page 2 of 4 Name: Date:

Chemical Facility Anti-Terrorism Standards (CFATS) Chemicals (cont’d)

Yes Quantity Liquids and Solids Yes Quantity (X) (in pounds) (X) (in pounds) Arsenic trichloride Boron tribromide Boron trichloride trifluoride Boron trifluoride N,N-(2-diethylamino) ethanethiol Bromine chloride o,o-Diethyl S-[2-(diethylamino) Carbonyl ethyl]phosphorothiolate pentafluoride Diethyl methylphosphonite N,N-Diethyl phosphoramidic dichloride [ethanedinitrile] N,N-(2-diisoproplyamino) ethanethiol N,N-Diisopropyl phosphoramidic Diborane dichloride Dichlorosilane N,N-(2-dimethyamino)ethanethiol N,N-Dimethyl phosphoramidic dichloride N,N-(2-dipropylamino) Germane ethanethiol

N,N-Dipropyl phosphoramidic tetrafluoride dichloride Hexafluoroacetone Ethylphosphonothioic dichloride Isopropylphosphonothioic dichloride (anhydrous) MDEA [methyldiethanolamine] Hydrogen selenide Methylphosphonothioic dichloride Methylchlorosilane Nitrobenzene (this is different than dinitrobenzene, which is not regulated) Nitrosyl chloride hydrochloride [Bis(2- difluoride chloroethyl)methylamine hydrochloride] Nitrogen trioxide oxychloride Selenium hexafluoride Propylphosphonothioic dichloride Stibine Thiodiglycol [Bis(2- hydroxyethyl)sulfide] tetrafluoride tetrachloride Tellurium hexafluoride Triethyl phosphite Trifluoroacetyl chloride Trimethyl phosphite hexafluoride

2018 Annual Survey of Biological and Chemical Agents regulated by Homeland Security Page 3 of 4 Name: Date:

4. Highly Restricted Chemical Facility Anti-Terrorism Standards (CFATS) Chemicals Yes Quantity CAS# (X) (in grams) 1,4-Bis(2-chloroethylthio)-n-butane 142868-93-7 Bis (2-chloroethylthio)methane 63869-13-6 Bis (2-chloroethylthiomethyl)ether 63918-90-1 1,5-Bis(2-chloroethlythio)-n-pentane 142868-94-8 1,3-Bis(2-chloroethylthio)-n-propane 63905-10-2 2-Chloroethylchloromethylsulfide 2625-76-5 1445-76-7 7040-57-5 DF (methyl phosphonyl difluoride) 676-99-3 Ethyl phosphonyl difluoride 753-98-0 HN-1 (nitrogen mustard-1) [Bis(2-chloroethyl)ethylamine] 538-07-8 HN-2 (nitrogen mustard-2) [Bis(2-chloroethyl)methylamine] 51-75-2 HN-3 (nitrogen mustard-3) [Tris(2-chloroethyl)amine] 555-77-1 Isopropylphosphonyl difluoride 677-42-9 1 [2-Chlorovinyldichloroarsine] 541-25-3 Lewisite-2 [Bis(2-chlorovinyl)chloroarsine] 40334-69-8 Lewisite-3 [Tris(2-chlorovinyl)arsine] 40334-70-1 Sulfur mustard (Mustard (H) [Bis(2-chloroethyl)sulfide] 505-60-2 O-Mustard (T) [Bis(2-chloroethylthioethyl)ether] 57856-11-8 Propylphosphonyl difluoride 107-44-8 QL [o-Ethyl-o-2-diisopropyl aminoethylmethylphosphonite] 3563-36-8 [Propylphosphonyl difluoride] 96-64-0 [1,2-Bis(2-chloroethylthio)ethane] 77-81-6 [o-Pinacolylmethyl phosphonofluoridate] 50782-69-9 [o-Ethyl-N,N-dimethlyphosphoramido-cyanidate] 690-14-2 VX [o-Ethyl-S-2-diisopropyl aminoethylmethyl phosphonothiolate] 63918-89-8

I have done a diligent search of the laboratory space under my possession, custody or control. I have verified that only those agents with completed information are in my or my employee’s possession, custody or control at the UofR.

Principal Investigator Signature Date

Name (print): Department:

Building: Lab room numbers:

Return the survey to Donna Douglass, Environmental Health & Safety, RC Box 278878 (or FAX to 274-0001 or email to [email protected]).

2018 Annual Survey of Biological and Chemical Agents regulated by Homeland Security Page 4 of 4