Hazardous Agent/Equipment Approval Request Form

Please complete this form if you plan to purchase/use hazardous materials and/or equipment (i.e. 3D printers, lasers, etc.) with potentially hazardous components. This form should also be completed when requesting a hazardous agent approval letter for IACUC protocols.

Requestor Name Requestor Name First Last
Requestor Email
List the space(s) where the materials and/or equipment will be used (Campus, Building, Room Number):
Are you the PI/Lab Manager for the space(s)?

Are you the PI/Lab Manager for the space(s)? Yes No
PI/Lab Manager Name PI/Lab Manager Name First Last
PI/Lab Manager Email
Please provide the list of materials/equipment below:
Safety Compliance

Complete the section below to the best of your knowledge. EH&S may request additional information when needed.
Ventilation is appropriate for the use of the materials/equipment in the space(s).

Ventilation is appropriate for the use of the materials/equipment in the space(s). Yes No Not sure - please contact EH&S at ehs@fiu.edu for further guidance.
Proper containment is provided for storage and use of hazardous materials (fume hood, biosafety cabinet, flammable cabinet, etc.).

Proper containment is provided for storage and use of hazardous materials (fume hood, biosafety cabinet, flammable cabinet, etc.). Yes No
All required applicable registrations/permits are in place and current (lasers, x-rays, radioactive materials, etc.).

All required applicable registrations/permits are in place and current (lasers, x-rays, radioactive materials, etc.). Yes No Not applicable
Standard Operating Procedures (SOPs) are in place for the use of the materials/equipment.

Standard Operating Procedures (SOPs) are in place for the use of the materials/equipment. Yes No
Please attach any support documentation that will assist with the review of this request (equipment manuals, SOPs, etc.).

Attach Files

Hazardous Agent/Equipment Approval Request Form

Hazardous Agent/Equipment Approval Request Form

Safety Compliance