1. Give the name and phone number of one person that you could contact if you have safety related questions.
2. Chemicals containers are color coded for identification of their hazardous properties. The color assigned to a chemical that is a health hazard is - a flammable chemical is .
3. MSDS is an acronym for .
4. You are working with a new chemical and need to read the MSDS - where can you find a copy? .
5. Give the location of the eye wash in your lab, for example, next to the door, northeast corner of lab. (If you do not have a lab, skip this question.) .
6. Department approved safety must be worn at all times in the student labs.
7. Appropriate clothing must be worn in the lab with coverage from the neck to the .
8. Fill out a lab a progress an accident report for all injuries - take the completed report to the Chem office SUB ballroom Student Health Center .
9. Describe what to do for a spill.
10. Describe what to do if the Fire Alarm sounds.

By submitting this form, I acknowledge that, in preparation for my job as an employee of the Chemistry Department, I have completed the following requirements:

• seen the department safety film
• received a copy of the department safety rules
• read "Safety in Academic Chemistry Labs"
• received information on who to contact if I have questions.

Name (Last, First): Job: TA RA SA Grad Student Faculty Staff

If applicable, Lab (SCI Room #:) Instructor's Name:

Send Form Erase Form