PRINCIPAL INVESTIGATOR:_________________________________________
BUILDING:__________________________________________________________
ROOM NUMBER:_____________________________________________________

1. Process Description



2. List Hazardous Chemicals/Chemical Class(es) and Expected By Products



3. Potential Hazards for each Process, Chemical or Material



4. Personal Protective Equipment Required



5. Engineering and Ventilation Controls Required



6. Special Handling and Storage Requirements for Chemicals and Materials 
      Used




7. Spill and Accident Procedures for the Process and Designated 
      Individual



8. Special Animal Use Precautions



9. Decontamination/Sterilization Procedures