NC STATE Home Page NC STATE UNIVERSITY - Environmental Health and Safety 2620 Wolf Village Way Cmpus Box 8007, Raleigh NC 27695  Phone 919.515.7915 FAX 919.515.6307 NC STATE Home Page

Safety Plan Forms

Safety Plan Forms


Goals & Objectives
The ACS Booklet
Control Measures
  & Medical Exam
Medical Surveillance

Request a new Safety Plan
Safety Plan Help

New Users or Transfer Use:

The following instructions are for researchers or managers using a lab or process location for the first time or have transferred their operation to another location.

All necessary information to complete your Safety Plan has been included in the Safety Plan Database. If you need more information please see Safety Plan Help.

The Safety Plan is used to educate occupants about the hazards unique to their work area and aid emergency responders. Moreover, the plan will highlight where especially hazardous processes and materials are used so EH&S may conduct comprehensive process safety reviews.

New users can submit a request for a new plan by going to Request a New Safety Plan and completing the required information.

You will add all the required infromation into your new plan and submit your additions via the database by certification and submission of the forms.  You will be contacted directly with any modifications required / suggested by the Safety Officer.  After final approval you will need to print a copy of your fully approved Safety Plan for posting in your laboratory space.

The ACS handbook Safety in Academic Chemistry Laboratories is intended to be the foundation of each safety plan. Each employee must read and understand all of the elements of the pamphlet. Please note that where the word 'should' is used in the pamphlet, the University treats it as 'will.' The manager or researcher will provide supplemental material about specific chemicals and hazards in their location.

EHS will supply each new user with a copy of the ACS handbook. The Handbook is to be kept with the Safety Plan.

If you use biological agents, toxins or do recombinant work, a BIOLOGICAL USE AUTHORIZATION MUST BE COMPLETED seperate from the safety plan process.

Please call Mahdi Fahim (5-1282) if you have questions or need assistance.

Supervisor Self-audit Checklist Certification This form is used to acknowledge that everything in the plan is accurate and complete, the PI has or will fill out the self-audit checklist and verify they are doing what is needed to minimize hazardous waste.

A COMPLETE UP-TO-DATE CHEMICAL INVENTORY to include any gas cylinders you may use in your laboratory location. DUE TO NEW REQUIREMENTS OF CHEMICAL CLASSIFICATIONS for Building Codes, THIS LISTING MUST BE SUBMITTED IN ACCESS OR EXCEL FORMAT. (Include your new updated plan number, principal investigator and lab location in the lower right corner of all inventory sheets.