Environmental Safety Forms
Key information and forms for UVM's
Environmental Safety Plan for
laboratories are available for download
to Managing Chemical Waste in UVM Laboratories
brochure (in PDF format) that describes UVM's chemical waste management
system and how you can Prevent Pollution
by reducing the amount of hazardous chemical
waste your work produces.
Chemical Use Planning Form
The Chemical Use Planning Form is designed to help laboratory
supervisors and safety officers outline
the precautions necessary for the use of
specific chemicals or groups of chemicals
with similar hazards. These forms are also
used to register the use of specific chemicals
with Environmental Safety for Institutional
Research Committee purposes. The form is
available in three formats:
In concert with Chemical Use Planning Form itself, the UVM Hazardous
Chemicals of Concern list (here in PDF
format) groups the most common laboratory chemicals
into hazard and compatibility groups and provides
information about special attention specific chemicals
need for safe management.
Laboratory Decommissioning Form
PDF Form to
notify us of a laboratory that is being decommissioned
and needs removal of excess chemicals.
Please give us at least three weeks notification
before the work must be completed.
The UVM Laboratory
Self Inspection cards in pdf format outline the monthly
inspections that UVM laboratories must conduct.
These are also used by Environmental Safety
auditors during laboratory visits. They are
printed in color; e-mail us for
pre-printed copy if the black
and white version here does not print well.
Emergency Eye Wash and
Shower Flush Log
calendar in pdf format for recording dates when eyewashes and
safety showers were flushed; self inspections
were conducted and any dates when the laboratory
was closed for use. These are also printed
in color; e-mail us for pre-printed
copy if the black and white version here does
not print well.
A description of the Environmental Safety training program
can be found on
our web page. We also have
of laboratory specific training in PDF format that
each supervisor should provide laboratory workers.
access to training records for training provided
by Risk Management & Safety staff. Requires UVM
NetId to use.
Bloodborne Pathogen Program Forms:
This form is for supervisors to use to designate a
specific laboratory worker as "at risk" for exposure to human
blood or body fluids. This designation means
that UVM is responsibile for providing access
to Hepatitis B vaccine series for this work.
Take this form to the medical provider who
provides the vaccination series and maintain
a copy in the laboratory safety notebook.
This form is completed by the employee to indicate
whether they consent to having the vaccine.
Copies should be kept with the risk designation
Last updated: January 3, 2007