Please fill out 1 form for each lab. Your sign will be posted in 5-10 business days.

Location Information:

Building	AMPAC-152 Arena-50 Bennett II-8116 Biological Science-20 Biological Science Field Station-92 Biomolecular Research Annex-8114 Burnett School of Biomedical Sciences -1001 Chemistry-5 Communications-75 CREOL-53 Engineering I-40 Engineering II-91 Engineering RP-319 Engineering Field Lab-44 Engine Test Facility-76 FSEC Lab Building-2002 Health & Public Affairs I-80 Health & Public Affairs II-90 LES-48 Math & Physics-12 OTC Suite 303-305-8113 OTC Suite 404-406-8113 Partnership I-8111 Physical Plant-16 Physical Science I-121 Research Pavilion-8102 Stormwater Management-4 Student Union-52 Theatre-6 Visual Arts Building-51 Other-(Use "Comments" box)	Number of Entrances to lab: 1 2 3 4
Room

Principle Investigator Information:

Name
Office Location
Work Phone
E-Mail
Emergency Phone*

Alternate Contact Information (Lab Manager, etc)

Name
Office Location
Work Phone
E-Mail
Emergency Phone*

*List emergency phone numbers for contact in the event of an after hours emergency.  Emergency numbers will not be posted on your sign.  

Check off up to seven of the following (six hazard and at least one personal protective equipment categories). A NFPA 704 diamond will automatically be added to signage for labs with hazardous chemicals or compressed gases:

Personal Protective Equipment- Check at least 1 Eye Protection Required at All Times        Eye Protection Required When Chemicals In Use      Eye Protection Required When Lasers In Use Eye Protection Required When Using Power Tools              Eye Protection Required When Chemicals/Lasers In Use Eye Protection Required When Chemicals/Power Tools In Use Wear Protective Clothing             No Open Toe Shoes               No Eating or Drinking
Bio, Chemical, Radioactive and Physical Hazards- Check up to 6
Biohazard Biohazard/Infectious Agent Biohazard/Recombinant DNA Biosafety Level 1         Biosafety Level 2               Biosafety Level 3             Laboratory Animals	Chemical Storage Area Corrosive Materials Toxic Chemicals Flammable Solvent Explosives Compressed Gas Toxic Gas Flammable Gas Cancer Hazard	Radioactive Materials X-Ray Equipment Radiation Producing Equipment Microwave Radiation Cryogenic Hazard Electrical Hazard High Voltage Laser Light Ultraviolet Light

           Comments or Additional Label Requests:

Environmental Health & Safety.
Revised: November 13, 2009