Appendix A
                                           PROJECT HAZARD AND CONTROL ANALYSIS

Department Name:
HAZARD GRADE:                   High               (         )         (potentially life threatening)
                                Medium             (         )         (potential for significant equipment of building damage)
                                Low                (         )         (minor equipment damage)
                                                                               Part I.
 Equipment Type                                                                Potential Hazards                     Y/N     Control Measures
 Previous Inspection Date                                                      High pressure or Vacuum
 Room No.                                                                      High temperature
 Current Inspection Date                                                       High voltage
 Experimenter(s)                                                               Risk of explosion
 Inspected By                                                                  Toxic materials
 Advisor(s)                                                                    Reactive/oxidizing materials
                                                                               Cryogenics/compressed gases
                                                                               Loss of air
                                                                               Loss of water
                                                                               Loss of power

Part II. Specify potential leak hazards: __________________________________________________________________
Part III. Spill Control for the following types of spills is available:           _________________________________________

Part IV. List principle hazardous chemicals used.                              Part V. Waste generation information
Location of MSDS:
       Item        Quantity           MSDS                MSDS
                                   Available ()       Reviewed ()                 Type of Waste          Quantity     Disposal Method
                                                                                                                       Available (describe)

Part VI. Safety Information
Emergency Contact Information                                                       First aid station location:
Phone number:
Location:                                                                           Required Personal Protective Equipment Available:

Emergency Shutdown Procedures posted:                                               Eye protection: Yes ( ) No ( ) Location:
Yes ( ) No ( )      Location:                                                       Foot protection: Yes ( ) No ( ) Location:
                                                                                    Hand protection: Yes ( ) No ( ) Location:
Emergency Safety Equipment
                                                                                    Apron/lab coat: Yes ( ) No ( ) Location:
Fire extinguisher location:
                                                                                    Respirator:       Yes ( ) No ( ) Location:
Eye wash fountain location:
Emergency shower location:

Part VII.           Historical safety problems ______________________________________________________________
Part VIII.          Inspection Committee Recommendations

Mandatory:          ______________________________________________________________________________________

Optional:           ________________________________________________________________________________________

Other Remarks _______________________________________________________________________________________
Attachments: UBC Hazard Control Assessment Form and Standard Operating Procedures for project including safety features.
                                                 Master copy available from HSE, call 604-822-5909.                                             1
                               UBC HAZARD CONTROL ASSESSMENT GUIDE

                                                 If a hazard exists, there is a means of controlling it.
There are four (4) types of controls to evaluate in the order given: a) elimination or substitution; b) engineering controls; c) administrative (e.g.
procedures, posters, work schedule, etc.); and d) personal protective equipment.

Note: Reference to procedures means specific procedures for materials/equipment/processes being used and includes relevant training.
  - Legend for abbreviations at end of table on page 2

               Type of Hazard                            UBC Procedure or                                        Hazard Control
                                                          Relevant Reg.
 1. Hazardous materials used and stored                 BC WCB Occupational               -   Substitute/minimize
 - hazards identified (e.g. flammability,               Health and Safety                 -   Use of fume hoods
     toxicity, reactivity)                              Regulation (WCB                   -   Install monitoring and alarm equipment
 - Potential significant inhalation exposures           OHSR); WHMIS; BC                  -   Use of appropriate containers & storage units;
     assessed                                           Fire Code; UBC                    -   Use of appropriate labels & MSDS available
                                                        Laboratory Chemical                      (WHMIS)
                                                        Safety Course Manual              -   Develop appropriate handling, disposal and
                                                                                                 emergency procedures
                                                                                          -   Develop appropriate signage and training procedures
                                                                                          -   Use of appropriate PPE
 2. Compressed gas used or stored                       BC WCB OHSR; BC                   -   Use minimum quantities in lab or shop
                                                        Fire Code; BC Gas                 -   Use appropriate means for securing and transporting
                                                        Safety Act                        -   Install monitors, alarms and signage as required
                                                                                          -   Develop written work and emergency procedures;
                                                                                          -   Ensure appropriate training is conducted
 3. Potentially violent reaction via:                   WCB OHSR                          -   Use of fume hoods
 - Rapid decomposition                                                                    -   Minimize quantities used; heat generated; other
 - Impact sensitivity                                                                            variables
 - Instability on storage to cold, heat, light,                                           -   Isolate or shield areas
      water, metals, etc.                                                                 -   Develop means of pressure relief
 - Mischarge or wrong addition order                                                      -   Use of redundant controls; automatic shutdown
 - Quantity and rate of evolution of heat and                                                    mechanism
      gases                                                                               -   Develop procedures to vent all parts of system before
 - water or air contact                                                                          breaking any lines
                                                                                          -   Use of appropriate storage areas
                                                                                          -   Develop appropriate handling & emergency
                                                                                          -   Use of appropriate PPE
 4. Radioactive material(s) or source(s)                CNSC Regulations ; BC             -   Use of fume hoods
     used?                                              WCB OHSR; UBC                     -   Follow CNSC procedures
                                                        Radionuclide Safety and           -   Follow UBC Radionuclide Safety and Methodology
                                                        Methodology Course                       Course procedures
                                                        Manual                            -   Develop appropriate emergency procedures
                                                                                          -   Use of appropriate PPE
 5. Infectious or biohazardous material(s)              BC WCB OHSR;                      -   Use of Biosafety cabinets and fume hoods
     used or handled?                                   WHMIS; CIHR                       -   Develop appropriate medical surveillance protocols
                                                        Guidelines; UBC                   -   Follow UBC protocols & procedures including
                                                        Biosafety Manual                         emergency procedures
                                                                                          -   Use of appropriate PPE
 6. Catalysts, inhibitors, or contaminants              BC WCB OHSR;                      -   Use of engineering controls
     (like iron) affect reactions?                      WHMIS                             -   Develop appropriate handling procedures
                                                                                          -   Develop written procedures & training
                                                                                          -   Develop appropriate emergency procedures

                                 Please call HSE @ 604-822-5909 to obtain the electronic version of this form.                                     2
                                                                  Appendix A

                Type of Hazard                         UBC Procedure or                                 Hazard Control
                                                        Relevant Reg.
    7. Energy Sources/Failures                        BC WCB OHSR; UBC                - Use of automatic shut-off system for:
    - Heating/cooling systems                         Lock-Out procedures; BC           - power
    - Power ( high voltage)                           Electrical Code; BC               - temperature
    - Machinery                                       Boiler & Pressure Vessel          - HVAC; ventilation;
    - Water; air                                      Code                              - pressure,
    - Ventilation                                                                       - water and air supply systems (back-up system)
    - Automatic controls or equipment                                                 - Use of appropriate signage
    - Pressure                                                                        - Use of lock-out procedures
    - Materials/equipment/container integrity                                         - Develop appropriate handling & emergency
                                                                                          procedures for fires/explosions and spills
    8. Possible generation of :                       WCB OHSR; BC Special            - Consider substitution of hazardous materials
    - Unacceptable odour                              Waste & other                   - Use of engineering controls:
    - Air pollution,                                  Environmental                       - fume hoods
    - Excessive noise,                                Regulations                         - PPE
    - Excessive heat,                                                                     - trap or back-flow preventor (1-way valve)
    - Sewer contamination                                                             - Use of noise testing and absorption materials
                                                                                      - Use of a cooling system
                                                                                      - Use of a waste trap
                                                                                      - Develop appropriate emergency procedures
    9. Hazardous waste(s) generated                   BC WCB OHSR; BC                 - Use of appropriate containers for storage
                                                      Special Waste & other           - Develop written procedures & training
                                                      Environmental                   - Develop appropriate emergency procedures
    10. Potential for impact of hazards of            BC WCB OHSR; BC                 - Notification of relevant personnel & organizations
        materials and process upset on                Environmental                       prior to incident
        neighbours, service, medical,                 Legislation                     - Develop process for notification of relevant personnel
        emergency response personnel, etc.                                                & organizations post-incident
                                                                                      - Develop appropriate emergency procedures
    11. Space for equipment, materials and            BC WCB OHSR                     - Create adequate and appropriate space
        experimental set-ups
    12. Asbestos-containing material                  BC WCB OHSR; UBC                - Conduct awareness training
        present.                                      asbestos handling               - Develop reporting procedures
                                                      procedures                      - Develop removal/substitution measures

-      BC = British Columbia
-      WCB = Workers’ Compensation Board
-      WHMIS =- Workplace Hazardous Materials Information System
-      PPE = Personal protective equipment
-      CNSC = Canadian Nuclear Safety Commission
-      CIHR = Canadian Institutes of Health Research
-      GVRD = Greater Vancouver Regional District
-      OHSR = Occupational Health & Safety Regulation

                                                 Master copy available from HSE, call 604-822-5909.                                          3

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