EAST CAROLINA UNIVERSITY HAZARDOUS CHEMICAL USE GRANT REVIEW FORM
ECU policy requires that all grant proposals involving the use of hazardous chemicals be reviewed by an institutional review committee or
their designee prior to initiation. The Office of Environmental Health and Safety (EH&S) serves as the review committee for the university. If
a grant proposal involves the use of hazardous chemicals, this form must be completed and submitted to EH&S at 210 East Fourth Street for
review and approval. Questions regarding the completion of this form should be directed to EH&S by calling 328-6166. Failure to provide all
requested information will delay the review and grant approval process.
Title of Project and Funding Agency:
Principal Investigator: Department: Location of Lab(s):
SECTION I – HAZARD CLASSIFICATION
The researcher must conduct a hazard classification for the chemicals utilized in the research activity. Check all categories that apply to the
chemicals used or produced in this research project. Hazard classification information may be obtained by reviewing MSDSs, container
labels and other reference material. Material safety data sheets are typically the primary starting point for classifying materials. Click on
each category for additional information.
DOT Class 1 Explosive DOT Class 6 Poison Toxic
DOT Class 2 Gas DOT Class 8 Corrosive Highly Toxic
DOT Class 3 Flammable Liquid Water Reactive Chemicals of unknown toxicity
DOT Class 4 Flammable Solid Sensitizer Carcinogen or Reproductive Toxin
DOT Class 5.1 Oxidizer Pyrophoric Chemicals do not meet any of the listed criteria
DOT Class 5.2 Organic Peroxide Cryogenic
The following substances have specific OSHA standards that may require exposure monitoring, regulated areas, medical surveillance, training
and other hazard control measures. Check all that will be used in this project. Click on each chemical for additional regulatory information.
4-Nitrobiphenyl alpha-Naphthylamine Inorganic arsenic 3,3'-Dichlorobenzidine (and its salts)
bis-Chloromethyl ether beta-Naphthylamine Benzidine N-Nitrosodimethylamine
Ethyleneimine beta-Propiolactone 2-Acetylaminofluorene 4-Dimethylaminoazo-benezene
4-Aminodiphenyl Asbestos Coal tar pitch volatiles Methyl chloromethyl ether
Formaldehyde Vinyl chloride Coke oven emissions 1,2-dibromo-3-chloropropane
Lead Cadmium Benzene
Cotton dust Acrylonitrile Ethylene oxide
Methylenedianiline 1,3-Butadiene Methylene Chloride
SECTION II – CHEMICAL INVENTORY
List all hazardous chemicals that will be used in this research project by chemical or product name and provide the chemical abstracts service
(CAS) number, quantity and location of each.
SECTION III – LABORATORY SAFETY PLAN
The researcher must submit to EH&S a laboratory safety plan that addresses the hazards associated with the chemicals used during this
research activity. This plan must identify the process, hazardous chemical/chemical class, potential hazards, engineering and ventilation
controls, personal protective equipment, special handling and storage requirements, spill and accident procedures, waste disposal procedures,
emergency evacuation procedures and employee information and training. (View a sample laboratory safety plan.) (Complete laboratory
safety plan online.)
SECTION IV – LABORATORY INSPECTION
The researcher must conduct a self-inspection of the research area using the checklist below. Verify that all inspection parameters are
satisfied and check the corresponding box. EH&S will inspect the research area annually and review self-inspection documentation. EH&S
must perform an initial inspection of the research area prior to grant approval. If the research area has not been inspected during the past
year, please contact EH&S at 328-6166 to schedule.
Food is stored/consumed outside the work area.
Appropriate hand washing facilities are provided in each lab.
Material Safety Data Sheets for all hazardous chemicals are available and readily accessible to all employees in the work area during each shift.
An inventory of all hazardous materials is maintained, updated and submitted annually to EH&S.
The ECU Chemical Hygiene Plan (CHP) is in each lab and readily accessible.
Hazardous chemicals are stored according to compatibility.
All containers are labeled with the complete chemical or product name and the associated hazard warning. Labels are legible and secure.
Hazardous waste labels include chemical constituents, associated percentages and appropriate hazard warning.
Appropriate personal protective equipment is provided and used.
Lab personnel wear appropriate lab attire. Shorts and open-toed shoes are not allowed.
Extension cords are not used in the place of permanent wiring.
Emergency numbers and evacuation procedures are posted in conspicuous locations in the lab.
All personnel have received appropriate lab safety training including information regarding health hazards associated with the chemicals used,
signs and symptoms of exposure, emergency procedures and measures that can be taken to protect personnel from exposure including safe work
practices, engineering controls and personal protective equipment. All training has been documented and records are available for review.
Chemical waste disposal has been coordinated with the Office of Environmental Health and Safety.
If fume hoods are used, they are operational and have been inspected within the past year.
If gas cylinders are used, they are properly secured and adequately ventilated.
All equipment and apparatus are inspected and maintained in accordance with manufacturer specifications.
When transporting chemicals within a building, containers are properly secured, sealed tightly and enclosed in secondary containment.
Contaminated personal protective equipment (lab coats, gloves, etc.) is removed prior to leaving the lab to prevent spread of contamination.
Also, appropriate personal protective equipment is used during transport.
The lab where this research is to be conducted has been inspected by EH&S within the past year and safety deficiencies identified during the
inspection have been addressed or an action plan has been approved by EH&S. A Lab Safety Plan has been completed and approved by EH&S.
I certify that to the best of my knowledge the information provided in this document is accurate. I agree to comply with current regulations
and university policies pertaining to laboratory safety and the use, storage, transfer and disposal of chemical agents. I will also abide by all the
provisions of the ECU Chemical Hygiene Plan. I also understand that I am responsible for ensuring lab personnel comply with these same
Signature of Principal Investigator: Date: Phone:
Signature of EH&S Review Staff: Date of Review: Approval Status: Pending