| Animal exposure / Vivarium |
Form A – Risk Assessment Work Evaluation Questionnaire for Employees or Affiliates with Animal Contact |
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| Animal exposure / Vivarium |
Form B – Medical History Questionnaire for Employees or Affiliates with Animal Contact |
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| Asbestos |
Asbestos Project Information Sheet |
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| Biosafety |
Biosafety Forms |
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| Confined space |
Confined Space Forms |
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| Controlled Substances |
PSDS- Applicant (for CSUA Lab Contacts and Authorized Personnel) |
PDF |
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| Controlled Substances |
PSDS- Principal Investigator (for Principal Investigators only) |
PDF |
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| Controlled Substances |
CS Self-Assessment Audit Sheet |
PDF |
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| Controlled Substances |
CS Usage Log (sample) |
PDF |
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| Controlled Substances |
CS Usage Log (additional page) |
PDF |
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| Controlled Substances |
CS Usage Log (for solutions only) |
PDF |
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| Controlled Substances |
Deactivation of Controlled Substances Use Authorization |
PDF |
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| Environmental protection & pollution prevention |
Environmental Compliance Assurance Form |
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| Environmental protection & pollution prevention |
Petroleum Container Inspection Checklist |
PDF |
Word |
| Environmental protection & pollution prevention |
Refrigerant: Contractor Input |
PDF |
Word |
| Environmental protection & pollution prevention |
Refrigerant: Cylinder Input |
PDF |
Word |
| Environmental protection & pollution prevention |
Refrigerant: Equipment Input |
PDF |
Word |
| Environmental protection & pollution prevention |
Refrigerant: Recover/ Recycling Unit Input |
PDF |
Word |
| Environmental protection & pollution prevention |
Refrigerant: RCM Service Order |
PDF |
Word |
| Ergonomics |
Ergonomic Resources Fund Request |
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| Emergency preparedness/ first aid kits |
Obtain and restock a research laboratory first-aid kit |
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| Emergency preparedness/ first aid kits |
First Aid Kit approved list for UC San Diego |
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| Fall Protection |
Fall Protection Safety Plan |
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| Field Operational Planner |
Urban Domestic Field Trips or University Conferences |
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| Field Operational Planner |
International Trips, Trips to Remote Areas, and/or trips involving special hazards (i.e. environmental, chemical, mechanical, etc.) |
PDF |
Word |
| Fire and life safety |
Food Truck Inspection Form |
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| Fire and life safety |
Fire Inspection Form |
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| Fire and life safety |
Fire Incident Form |
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| Food facility temporary permit applications |
Off-Campus / Commercial Temporary
Food Facility Permit Application |
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| Food facility temporary permit applications |
On-Campus / Non-Profit and Student Organizations
Temporary Food Facility Permit Application |
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| Hazardous waste |
Online Waste Tag Program (OTP) |
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| Hazardous waste |
Hazardous Waste Generator Number Application |
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| Hazardous waste (Determination) |
Waste Determination Form |
PDF |
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| Heat Illness Prevention Program |
Supervisor HIP Compliance Checklist |
PDF |
Word |
| Heat Illness Prevention Program |
Worksite HIP Worksheet |
PDF |
Word |
| Hot Work Program |
Hot Work Permit and Checklist |
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| Hot Work Program |
Activity Logs |
PDF |
Word |
| Injury & Illness Prevention Program (IIPP) |
Accident Investigation (how and why it happened) |
PDF |
Word |
| Injury & Illness Prevention Program (IIPP) |
Campuswide IIPP Program document |
PDF |
Word |
| Injury & Illness Prevention Program (IIPP) |
Custodial Storage Area Inspection Checklist (for HDH) |
PDF |
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| Injury & Illness Prevention Program (IIPP) |
Dining Facility Safety Inspection Checklist |
PDF |
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| Injury & Illness Prevention Program (IIPP) |
Employee Safety Recommendation |
PDF |
Word |
| Injury & Illness Prevention Program (IIPP) |
Facilities Services Safety Training Catalog |
PDF |
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| Injury & Illness Prevention Program (IIPP) |
Hazard Identification |
PDF |
Word |
| Injury & Illness Prevention Program (IIPP) |
Office Safety Inspection |
PDF |
Word |
| Injury & Illness Prevention Program (IIPP) |
Safety Training Roster |
PDF |
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| Injury & Illness Prevention Program (IIPP) |
Shop & Studio Safety Inspection Report |
PDF |
Excel |
| Injury & Illness Prevention Program (IIPP) |
Shop & Studio Safety Inspection Checklist |
PDF |
Excel |
| Injury & Illness Prevention Program (IIPP) |
Supervisor's Safety Meeting |
PDF |
Word |
| Ladder and lifts safety |
Ladder inspection form |
PDF |
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| Laser safety |
Laser Safety Forms |
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| Lead-Based Paint Management Program |
Lead-Based Paint Project Information Sheet |
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| Lockout/ Tagout |
LOTO Training form |
PDF |
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| Lockout/ Tagout |
LOTO Use forms |
PDF |
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| Occupational Health & Hygiene |
Inventory of Tasks Performed with Materials Containing Crystalline Silica |
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| Personal protective equipment (PPE) |
PPE Hazard Assessment (non-research) |
(PDF, English) (PDF, Spanish) |
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| Personal protective equipment (PPE) |
Embroidered Lab Coat Fitting Form |
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| Personal protective equipment (PPE) |
Lab Coat Laundry Envelope Request Form |
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| Personal protective equipment (PPE) |
Additional PPE Request Form |
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| Personal protective equipment (PPE) |
Undelivered or Missing Lab Coats |
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| Pest Control |
Request Pest Control Services |
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| Radiation safety |
Radiation Safety Forms: Health System Employees |
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| Radiation safety |
Radiation Safety Forms: Research Employees |
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| Report a Safety Concern to EH&S |
Report a Safety Concern |
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| Work-Related Injury, Illness, or Exposure |
Student and Visitor Incident Report |
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| Work-Related Injury, Illness, or Exposure |
Employee's Occupational Incident Report |
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| Work-Related Injury, Illness, or Exposure |
Supervisor's Occupational Incident Report |
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| Research safety |
Chemical Abbreviations and Annotations |
(PDF) |
Word |
| Research safety |
Controlled Substances - see the Controlled Substances section above |
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| Research safety |
Decontamination Clearance Request |
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| Research safety |
Environmental Compliance Assurance Form |
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| Research safety |
First Aid Kit approved supplied list |
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| Research safety |
First-Aid Kit: Obtain and Restock Form |
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| Research safety |
Laboratory Hazard Assessment Tool (LHAT) |
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| Research safety |
Laboratory Relocation or Closure Notification |
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| Research safety |
Magnet Registration |
PDF |
Word |
| Research safety |
New Laboratory Worker Checklist |
PDF |
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| Research safety |
Principal Investigator Information |
PDF |
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| Research safety |
Minors in Lab Packet |
PDF |
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| Research safety |
Self-Audit Lab Form |
PDF |
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| Research safety |
Waste Determination Form |
PDF |
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| Respiratory protection |
Hazard Evaluation - For Respirator Use Request |
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| Respiratory protection |
Medical Evaluation Questionnaire for Respirator-Use Certification |
PDF |
Word |
| Risk management (liability insurance) |
Risk Management Forms |
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| Safety Award For Excellence (SAFE) |
Safety Award For Excellence (SAFE) form |
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| Special events |
Special Events Checklist Tool - On-Campus Events |
PDF |
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| Workers' compensation |
Designation of Physician |
PDF |
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| Workers' compensation |
Employee's Occupational Incident Report |
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| Workers' compensation |
Supervisor's Occupational Incident Report |
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| Workers' compensation |
Incident Report for Students & Visitors |
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| Workers' compensation |
OSHA Form 300A: Summary of Work-Related Injuries and Illness |
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| Workers' compensation |
Workers' Compensation Time of Hire Form |
English PDF,
Spanish PDF |
English Word, Spanish Word |
| Workers' compensation |
Temporary Job Accommodation Interactive Process TRTW Form |
(PDF) |
Word |
| Workers' compensation |
Pharmacy Benefit Network pamphlet Form |
(PDF) |
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