_PRINT_

							            Chemical and Materials Engineering Laboratory Guidelines
                               Revised 11/4/2011


(PRINT)
            Last Name                         First Name                          Middle Name

 ACKNOWLEDGMENT OF UNDERSTANDING SAFE LABORATORY PRACTICES
                     AND MSDS SHEETS

1.     I understand that I am responsible for consulting the MSDS for every material that I will
       be working with in the lab.

2.     I understand that eye protection must be worn at all times in the laboratory, specifically
       that safety goggles must be used when handling Chemicals.

3.     I understand that appropriate gloves must be worn, as indicated by the MSDS, when
       handling toxic, caustic, reactive, or corrosive compounds.

4.     I understand that shorts, open toed shoes, and short sleeve shirts are not acceptable attire
       for any of the CME Department laboratories.

5.     I understand that students are not allowed to work alone in the laboratory.

6.     I understand that I am to immediately report any unsafe laboratory conditions to a CME
       Department faculty member.

7.     I understand that I am to immediately report anyone acting in an unsafe manner in the
       laboratory to a CME Department faculty member.

8.     I understand that I am to read all equipment manuals before using any equipment in the
       CME Department Engineering laboratories.

9.     I understand that I am to maintain my workspace in a clean, uncluttered manner at all
       times. When I am through working, I am to wash all glassware, and wipe down all
       counters that I was working at.

10.    I understand that all containers (such as beakers, flasks, burets, etc.) must be labeled
       with the name of the contents (including estimates on composition of each component),
       students name, and date.

11.    I understand that all unused chemicals and chemical waste must be stored in appropriate
       containers (i.e. glassware is not appropriate for caustics).

12.    I understand that I am responsible for knowing the location and method of operation for
       all safety equipment in the lab, including the safety shower, eye wash, respirator, and
       safety goggles.




Signature                                                            Date
             Chemical and Materials Engineering Laboratory Guidelines
                                   Revised 11/4/2011
13.    I understand that I am responsible for immediately reporting to one of the CME
       Department faculty members, any damaged or malfunctioning safety equipment that I
       find in the lab.

14.    I understand that I am responsible for informing others who are working in the lab of
       any special safety precautions involved in any work that I am doing in the lab.

15.    I understand that I am not to work with any chemical or use any equipment in the lab
       without obtaining approval from one of the CME Department faculty member.

16.    I understand that I am to consult with a CME Department faculty member regarding any
       questions I have about equipment and / or chemicals before I begin using them.

17.    I understand that a clear pathway to all exits, safety equipment, and circuit breakers
       must be maintained at all times, i.e. no desks or equipment should block the aisles in the
       laboratory.

18.    I understand that any malfunctioning or broken equipment must be immediately reported
       to a CME Department faculty member.

19.    I understand that proper procedures must be followed when cleaning up spilled
       chemicals in the CME Department laboratories, as directed by the MSDS, including
       notification of appropriate authorities.

20.    I understand that NO chemicals, other than water, are to be disposed of in the sinks.

21.    I understand that glassware is to be disposed of only in containers specifically labeled
       for that purpose and NOT IN THE TRASH CANS.

22.    I understand that empty chemical containers must be defaced and SHOULD NOT be
       used for storage.

23.    I understand that chemicals should not be returned to their original containers after they
       have been removed, even if they were not used.

24.    I understand that unauthorized visitors are not allowed in the CME Department
       laboratories.

25.    I understand that in the case of an emergency that I should evacuate immediately and
       sound the alarm as I exit.

26.    I understand that Material Data Safety Sheets (MSDS) provide information about
       chemical substances in a product, safe handling procedures, first aid measures, and
       procedures for handling accidental spills or leakage of the product.

27.    I understand that the American Conference of Governmental Industrial Hygienists
       (ACGIH) lists an annual update of chemicals to be included on an MSDS.


Signature                                                           Date
            Chemical and Materials Engineering Laboratory Guidelines
                               Revised 11/4/2011

28.    I understand that the health hazards recognized by OSHA for inclusion on an MSDS are:
       (1) Carcinogen; (2) Toxic agent; (3)Highly toxic agent; (4)Reproductive toxin; (5)
       Irritant; (6) Corrosive (to tissue); (7) Sensitizer; (8) Hepaotoxin (liver); (9) Nephrotoxin
       (kidney); (10) Neurotoxin (nervous system); (11)Agents which act on the hematopoietic
       (blood) system; and (12) Agents which damage lungs, skin, eyes or mucous membrane;
       and that it is my responsibility to understand the nature of these health hazards.

29.    I understand that known and potential carcinogens are reported by the National
       Toxicology Program (NTP) in the Annual Report on Carcinogens, by the
       International Agency for Research on Cancer (IARC) in Monographs, and by OSHA,
       and that these findings are compiled in the NIOSH Registry of Toxic Effects of
       Chemical Substances.

30.    I understand that OSHA Personal Exposure Limit values are found in the General
       Industry Standards & that the annually updated ACGIH TLV values are found in
       Threshold Limit Values and Biological Exposure Indices and that these values are
       usually listed in (mg/m3) or ppm.

31.    I understand that the physical hazards recognized by OSHA for inclusion on an MSDS
       are: (1) Combustible liquid; (2) Compressed gas; (3) Explosive; (4) Flammable: aerosol,
       gas, liquid, or solid; (5) Organic Peroxide; (6) Oxidizer; (7) Pyrophoric; (8) Unstable
       (reactive); and (9) Water Reactive; and that it is my responsibility to understand the
       nature of these physical hazards.

32.    I understand that the generic name should be used when listing extinguishing media, and
       that the standard fire fighting agents are water, fog, foam, alcohol foam, CO2, and dry
       chemical and that I am responsible for knowing what each agent is.

33.    I understand that I am responsible for knowing the: flash point, autoignition
       temperature, flammable limits in air, extinguishing media, special fire fighting
       procedures, and unusual fire and explosion hazards included in the Fire and Explosion
       Hazard Data section of the MSDS for any hazardous material that I will be using in the
       laboratory.

LIST OF DEFINITIONS
D.1   Flash Point: Temperature at which the liquid will give enough vapor to ignite, and that
      the OSHA recognized method of measurement must be included as Tagliabue closed
      tester, Pensky - Martins closed tester, or Setaflash closed tester.

D.2    Autoignition Temperature: Minimum temperature needed to cause self sustained
       combustion with the introduction of a spark or flame.

D.3    Flammability Limits in Air: Listed in percent by volume, and whether the material was
       tested as a dust.




Signature                                                            Date
             Chemical and Materials Engineering Laboratory Guidelines
                                Revised 11/4/2011
D.4    Asphyxiant: Vapor which can cause injury by reducing the amount of oxygen available
       for breathing.

D.5    Corrosive: Chemical which causes visible destruction or irreversible alteration of
       human skin at the site of contact, or has a corrosion rate on steel of more than 0.250 inch
       per year.

D.6    Oxidizer: Chemical that initiates or promotes combustion in other materials.

D.7    Pyrophoric Material: Chemical or mixture that will ignite spontaneously in dry or moist
       air at < 130 _F.

D.8    Sensitizer: Chemical that causes a substantial number of persons to develop a
       hypersensitive reaction in normal tissue upon reapplication of the chemical substance or
       mixture, through an allergic or photodynamic reaction.

D.9    Toxic: Chemical falling within any of the following categories: (1) having a lethal dose
       (LD50) of greater than 50 mg / kg but less than 500 mg / kg of body weight; (2) having a
       lethal dose (LD50) of greater than 200 mg / kg but not more than 1000 mg / kg when
       administered by continuous contact for 24 hours; (3) having a lethal concentration in air
       (LC50) of more than 200 ppmv but not more than 2000 ppmv.

D.10   Highly Toxic: Chemical falling within any of the following categories: (1) having a
       lethal dose (LD50) of 50 mg / kg of body weight; (2) having a lethal dose (LD50) of < 200
       mg / kg when administered by continuous contact for 24 hours; (3) having a lethal
       concentration in air (LC50) of < 200 ppmv.

D.11   Median Lethal Dose (LD50): Dosage that is most likely to kill 1/2 of a group of test
       animals using a specified test procedure with the specification of oral or skin exposure.

D.12   Threshold Limit Value (TLV): Airborne concentration of the substance under which it
       is believed nearly all workers may be repeatedly exposed day after day without adverse
       effect.

SPECIAL SECTIONS OF THE MATERIAL SAFETY DATASHEET
S.1  Special Fire Fighting Procedures Section: Lists any special personal protective
     equipment required including respirator selection, clothing, eye protection, and / or Self
     Contained Breathing Apparatus (SCBA).

S.2    Reactivity Hazard Data Section: Includes information regarding the stability of the
       chemical during transport, incompatibility with other chemicals, hazardous
       decomposition products, and hazardous polymerization, and the associated high rate of
       energy release.

S.3    Health Hazard Section: Lists the chronic effects of the chemical, including whether the
       chemical is a carcinogen, tetraogen (tumor causing), mutagen (genetic), and whether it
       causes blood dyscrsias (anemia), chronic bronchitis, liver atrophy (degeneration), or

Signature                                                           Date
            Chemical and Materials Engineering Laboratory Guidelines
                                  Revised 11/4/2011
       kidney damage. This section also includes signs and symptoms of exposure, with
       emphasis on exposure to the eyes, the skin, inhalation, and ingestion; medical conditions
       aggravated by exposure; and emergency first aid procedures.

S.4    Control and Protective Measures Section: Includes: ventilation required during use of
       the chemical, hygienic work practices, and personal protective equipment required
       including type of gloves, eyewear, ear protection, and other clothing.

S.5    Precautions for Safe Handling and Use / Leak Procedures Section: Includes information
       regarding waste disposal methods, storage precautions, and NPFA rating (optional).

MISCELLANEOUS PHRASES
M.1 Chronic effects of exposure: Refers to the adverse effects that develop slowly over a
     period of weeks, months, or years upon repeated exposure to a substance without
     implying severity.

M.2    The abbreviation for parts per million volume is ppmv.


I have read and understand the list of definitions ( D1-D12), special sections of the MSDS
(S1-S5), and miscellaneous phrases (M1 and M2).

I UNDERSTAND THAT IF I DO NOT ADHERE TO THESE SAFETY PRACTICES I
WILL BE EXPELLED FROM THE LABORATORY. MULTIPLY EXPULSIONS
WILL RESULT IN PERMANENT EXCLUSION FROM THE CME DEPARTMENT
LABORATORIES.




Signature                                                          Date