Environmental Health and Safety - Laboratory Signage Request

Laboratory Signage Request

This form should be used to request the preparation of laboratory signage in accordance with the City of Pittsburgh and Allegheny County requirements for notification of laboratory hazards. Some fields are required to be completed. These are marked with *. After completion of the request form, the sign will be prepared and forwarded to you through campus mail. Thank you for your participation in this program.

Required Information

* Building:
* Room:
* Department:
* Primary Responsible Person:
* Campus Phone:
* Emergency Phone:

Alternative Contacts

Please enter information for additional persons knowledgeable about the chemicals and functions of the laboratory in the event that the Primary Contact is unavailable.

* Secondary Contact:
* Emergency Phone:
Tertiary Contact:
Emergency Phone:

Laboratory Contents & Hazards

Please enter the following information related to the laboratory's contents and hazards. This is not a full laboratory inventory. This listing is for classes of materials of concern in the event of a laboratory emergency. Please include approximate quantities of these materials.

Additional Info

Please enter information related to any additional specific hazards or special precautions: