Group Member Contact Information. Laboratory Supervisor: Off campus tel: Off campus tel: Name, room Address Phone Number

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Group Member Contact Information Laboratory Supervisor: Off campus tel: Off campus tel: Name, room Address Phone Number

Record of Safety Training Completed by Workers Worker s Name (printed) Safety Training Course Date Completed Initials (attach certificate in appendix, if available) Worker Supervisor

Record of group specific training Trainer Trainee Description of Training Date

Supervisor Laboratory Inspection Record Supervisor name: Lab locations: Date Safety comments/problems to be addressed (communicated to group) Signature

New Employee Lab Orientation Checklist Employee Name: Date: Safety Glasses must be worn at all times where hazards are present Footwear must cover the entire foot No bare legs No food/food garbage in labs Call 911 for all emergencies Locations and use of PPE (gloves, apron, shield, oven mitts), where applicable Safety glasses for visitors, laser safety glasses for visitors, whenever necessary Requirement for Radiation Safety Awareness for visitors, if applicable Locations of primary and secondary fire exits Locations and use of fire alarm pull stations Location and use of fire extinguishers and class (including metals) Location and use of fire blanket Locations of lab fire/emergency plan Locations and use of chemical spill kits Locations and use of safety showers Locations and use of eyewash stations Location of first aid kit Report all injuries or dangerous incidents to supervisor immediately Doors must be locked when lab unoccupied Locations and use of chemical waste disposal supplies and pickup Awareness of hazardous equipment in lab Location of equipment manuals Location of SOPs, when applicable Location of lab safety manual, when applicable Location of radiation safety manual, when applicable Location of biosafety manual, when applicable Location of X-ray safety manual, when applicable Location of laser safety manual, when applicable Chemical storage locations in labs Location of MSDS information and hazardous materials inventory list, when applicable. Location of broken glass container, if applicable Pointers on the use of pressurized gas cylinders List of required OHS training courses Location of emergency phone list of employees A hazardous position communication form has been completed by the employee, when applicable (staff and graduate students). Found at: http://www.wph.uwo.ca/newposition.htm Designated substances - identified on campus: lead, mercury, arsenic, benzene, isocyanates, asbestos, and crystalline silica with particle sizes < 10μm (not chromatography or TLC silica). Don t be afraid to ask if there is a concern Employee Signature: Supervisor Signature:

Department of Chemistry Western University Requirements for Laboratory Work 1. WORKPLACE HAZARDOUS MATERIALS INFORMATION SYSTEMS (WHMIS) Canada is adopting new international standards - the Globally Harmonized System of Classification and Labelling of Chemicals (GHS). This includes Safety Data Sheets (SDS) and a new labelling system that is already appearing on some new chemicals Western labs. At Western this means: New WHMIS training in now available on OWL. The new version replaces both the Basic WHMIS, and Comprehensive WHMIS training that were available in the past. In addition to the mandatory training at the beginning of new employment at Western, all existing Western All staff, faculty, graduate students, work study and co-op students and volunteers at Western will be required to also take the new version of online WHMIS training, even if you recently completed the older version. The new training course will take approximately 1.5 hours to complete. At the completion of the course, the participant will be able to: Understand what WHMIS 2015 is and why it is important to workers Understand what GHS is and how it affects WHMIS 2015 Identify the WHMIS 2015 hazard classes and symbols Identify the types of information covered on supplier and workplace labels Understand the purpose, content and function of a Safety Data Sheet (SDS) Understand the hazards associated with controlled products Know your legal rights and duties under WHMIS 2015 Occupational Health and Safety offers of WHMIS training for all UWO Employees New WHMIS 2016 training is now available online through OWL http://owl.uwo.ca. 2. HEALTH AND SAFETY ORIENTATION Work Safely at Western Mandatory for all Western staff, faculty, graduate students, undergraduate students working in a lab, work study students and volunteers. On completion of this 40 minute session the participant will be able to: Understand your basic rights and responsibilities and those of other workplace parties under the Occupational Health & Safety Act of Ontario o The Right to Know o The Right to Refuse Unsafe Work o The Right to Participate Know who your Health and Safety partners are at Western Know what workplace hazards are and what to do if you see a workplace hazard. Know the proper response to campus fires and emergencies. Know your duty to report workplace accidents and incidents. This course is available online via OWL at http://owl.uwo.ca (The University of Western Ontario section.) 3. LABORATORY SAFETY HAZARDOUS WASTE Register for in class safety training at: http://uwo.ca /humanresources/peoplesoft/training/howto_register.htm Sessions are mandatory for laboratory supervisors and workers. (A worker is anyone who conducts a procedure in a laboratory.) At the completion of this presentation, the participant will be able to: understand the common hazards associated with laboratory work and how to identify them use the proper precautions for the identified hazards explain the proper use of the laboratory fume hood select the appropriate personal protective equipment for the task Page 1 of 3

respond properly to a laboratory emergency understand the different types of waste and how to process each segregate chemicals appropriately for both waste disposal and storage complete labels and inventory forms and package the wastes properly 4. LABORATORY ORIENTATION Safety is a shared responsibility between you, your co-workers and supervisor. Your supervisor MUST acquaint you with the location and operation of all building safety devices such as the fire alarm tone, eyewash, safety shower, fire extinguishers, fire blankets, first aid kits, evacuation routes and exits, spill control and containment kits, laboratory evacuation procedure, etc Familiarize yourself with the Safety link on the Departmental website: http://www.uwo.ca/chem/ You and your supervisor must also review the operation of the fume hoods and all other instrumentation you may need to operate. The supervisor and employee MUST complete the orientation checklist and file tin the lab safety binder in your laboratory. 5. LABORATORY WORKING HOURS AND CONDITIONS You should not work in the laboratory alone (Laboratory Safety Manual, 8.2). A qualified graduate student, post-doctoral fellow or faculty member also be present. Consult your faculty supervisor as to whom he/she designates as qualified for the work you will be performing. It is you and your supervisor s shared responsibility to ensure that at least one of those persons is present. It is your right to work in a safe working environment. It is your supervisor s responsibility to ensure that your working environment is safe. It is your responsibility to tell your supervisor of any conditions that you believe are unsafe. Until you are satisfied that your working conditions are safe, you can refuse to work. 6. ADDITIONAL REQUIRED TRAINING BASED ON WORK AREA/STUDY There are additional safety trainings you may be required to take in a class environment. Please check with your supervisor. The following is a list of courses you may need to sign up for: Biosafety, Radiation Safety Nuclear, Radiation Safety Refresher, Radiation Safety Awareness, X-ray Safety, Laser Safety, and Biological Safety Cabinets. To register for safety trainings, visit OWL, which will be automatically set up for the new faculty, staff and other designated Western relationships once all information has been establish on myhr a few days after your contract has been submitted to Human Resources. Read more at the following link: http://www.uwo.ca/humanresources/facultystaff/h_and_s/training /howto_register.htm To register for any of these courses, please visit this web-site: http://uwo.ca/humanresources/peoplesoft/training/howto_register.htm REMEMBER, SAFETY IS A SHARED RESPONSIBILITY BETWEEN YOU AND YOUR SUPERVISOR To ensure that you and your supervisor understand the importance of safety in all laboratories in the Department of Chemistry, please complete the following: I, (Supervisor) have read the above and will ensure that (Laboratory Worker) has understood and will comply fully with the above conditions before beginning any work. Signed: Date: (Supervisor s Signature) I, (Laboratory Worker) have read the above and will ensure that I comply fully with the above conditions before beginning any laboratory work. Signed: Date: (Laboratory Worker s Signature) Only after completion of this form can keys to the laboratory be issued. cc: Supervisor Laboratory Worker Page 2 of 3

Department of Chemistry Western University CONDITIONS OF KEY ISSUANCE The keys for the rooms and perimeter access is listed below will only be issued under the following conditions. 1. The form, SAFETY REQUIREMENTS FOR LABORATORY WORK, has been completed and returned. 2. That all conditions for the issuance of keys and by the Keys Office have been met. 3. That all keys must be returned at the end of your employment/study in the Department of Chemistry. Failure to return your keys may result in the following penalties. STUDENTS: Withholding of final marks and/or paycheque until keys are returned. EMPLOYEES: Withholding of final paycheque until keys are returned. 1. This form requires the signature of the laboratory supervisor and the student before an on-line Request for Key(s) can be submitted. 2. Electronic Access request will be submitted by Clara Fernandes upon receipt of this form. LABORATORY SUPERVISOR: Please authorize the room number(s) for the keys(s) to be issued. ChB, ChB, MSA, MSA. ChB, ChB, B&G, B&G. ELECTRONIC ACCESS: MSA Electronic Access: 3 rd Floor Ground Floor Chemistry Building Access Perimeter: YES NO (Authorizing Signature of Supervisor) (Date) EMPLOYEE / STUDENT: I have read the above and agree to the conditions. (Student Signature) (Date) Page 3 of 3

The Chemistry Building The University of Western Ontario September 2017 Special Safety Procedures All practices, guidelines and policies in the Laboratory Health and Safety Manual for General Laboratory Practices are policy for the Western University and also apply to The Department of Chemistry. See http://www.uwo.ca/chem/safety/ for additional information. Above Laboratory Health & Safety Manual for General Laboratory Practices is available at: http://www.uwo.ca/hr/form_doc/health_safety/doc/manuals/lab_safety_manual.pdf In addition, there are a few specifics about our building. 1. The FIRE ALARM is a ringing bell. If you hear it, evacuate immediately by the nearest exit (see the evacuation plan for your lab space). The Chemistry Building is on a separate fire system than the Biological and Geological Sciences Building/Material Sciences Addition. You can evacuate ChB by going into BGS/MSA (or vice versa) if the alarm in that building has not been activated. If you have personal belongings close at hand (i.e., keys) be sure to take them. It could be days until you are able to reenter!! 2. If you have a spill or the accidental/inadvertent release of chemicals in the lab (a BAD SMELL ) follow the procedures outlined in blue book Section 11.6. Until the source of the smell can be adequately contained and controlled it is essential that the smell be contained within the lab. Close all doors and NEVER, NEVER OPEN THE WINDOWS. If building evacuation is not required, post a sign (or a coworker) at the door to prevent entry, get your supervisor (or a competent designate who has been formally assigned by your supervisor), Zhifeng Ding (Extension 86161, MSA 0203 (G)) and/or call OH&S (82036) during business hours, otherwise call 911 (if appropriate). Remember, your first priority is life safety; the building and facilities are secondary. 3. If there is a fire in your lab, follow the procedures in the blue book Section 11.7 and remember that... a) never attempt to put out a fire that is larger than a basketball. b) you are not obliged to fight a fire, you are in the lab as a researcher not a fire fighter. If you are uncomfortable, evacuate all workers and pull the fire alarm. After evacuation meet Zhifeng Ding and/or the firefighters and/or call 911. Special Safety Procedures 1

4. If you have a bad smell in your lab (localized) that you have determined does not originate in your lab, it is most likely entering through the sewer system. It is probably due to a dry sink trap. Fill all traps by running water into the sinks. If the smell persists after you have filled all traps call Zhifeng Ding at Extension 86161. If you are uncomfortable follow the evacuation procedure above. 5. If any of the building facilities are not working (ie. Electrical, plumbing, ventilation, light, heat, water, air, vacuum, fumehoods, air conditioning, locks, doors, latches, faucets, drains, hinges, fire extinguishers low, etc.) These are Western University maintenance items and can be fixed FREE. It won t cost your supervisor anything. 6. After life-threatening safety issues have been dealt with, report all accidents and incidents to your supervisor and Zhifeng Ding. An incident report must be filled out and will be reviewed by the Department of Chemistry Safety Committee. 7. If you are unsure about a procedure STOP. Seek competent advice. 8. When transporting goods from ChemBioStores and around the building please use proper methods (ie. Gas carts for cylinders, solvent carriers for solvents). If in doubt please talk to the personnel in ChemBioStores. 9. When delivering items for repair or rework in the Glassblowing Shop or the Electronics Shop please be sure the items are clean and free of chemical contamination. 10. Our Hazardous Waste Pickup is weekly, on Thursdays at 10:30 a.m. SHARP. You must accompany your waste to the pickup and ensure that is labelled. ChemBioStores has labels. Your lab may have a designated person who transports lab waste. 11. There is the misconception that individual fumehood stacks join/mix as they leave each hood. This is not true. The airstreams only mix outside the building, above the roof, beside the stainless steel stacks. 12. If you need a circuit breaker reset and your panel is locked, first assess why the breaker tripped and reduce the load. Breakers trip for a reason. Chemistry Special Safety Procedures 2