General Audit Checklist

P.I.

Date:

Dept.:

UA#:

Category A

ID #

Description

Status

Other

Other

Comments

G8a

Note if the laboratory added (A) or deleted (D) use of:

Currently uses

RAM

A D

Y N

Biological Materials

A D

Y N

Chemicals

A D

Y N

Controlled substances

A D

Y N

Registered Carcinogens

A D

Y N

1) If added, process an application.

2) If deleted, process a closure.

G8b

Note if the laboratory added (A) or deleted (D) any item to/from their current use:

RAM

A D

Y N

Biological Materials

A D

Y N

Chemicals

A D

Y N

Controlled substances

A D

Y N

Registered Carcinogens

A D

Y N

If A or D, process an application to update their current permit.

G4a

All use location(s) approved:

RAM

Y N NA

Add Delete

Biological Materials

Y N NA

Add Delete

Chemicals

Y N NA

Add Delete

Controlled substances

Y N NA

Add Delete

Registered Carcinogens

Y N NA

Add Delete

If NO, process an application and obtain a diagram.

G3a

All personnel approved:

RAM

Y N NA

Add Delete

Chemicals

Y N NA

Add Delete

Controlled substances

Y N NA

Add Delete

Registered Carcinogens

Y N NA

Add Delete

Biological Materials

Y N NA

Add Delete

If N, for RAM or biological material users obtain a "Supplement A Form". For Controlled substances, a User Form is needed.

Equipment

Unobstructed & Clutter Free

B7a

BSC annual certification current

S NS NA

NA

R7c

Survey instrument calibration current

S NS NA

NA

C7a

Fume hood inspection current

S NS NA

Y N

C7b

Deluge shower inspection current

S NS NA

Y N

C7c

Eye wash inspection current

S NS NA

Y N

B7b

Autoclave usage change

S NS NA

If NS, make change on the Autoclave Form

B7c

Autoclave monthly QC done (medical waste only)

S NS NA

HAZARDOUS MATERIALS STORAGE

RAM

R6g

Properly shielded

S NS NA

R8i

Security adequate

S NS NA

Chemicals

C8b

Properly segregated

S NS NA

C7d

Approved flammable cabinet present

S NS NA

C7e

Corrosive cabinet present

S NS NA

C5d

Use of funnel for pouring

S NS NA

Gas Cylinder

C7f

Properly secured

S NS NA

C7g

Caps on (when not in use)

S NS NA

Biological Materials

B5e

Properly stored

S NS NA

INVENTORY CONTROL

RAM

R8h

Sealed sources inventoried

S NS NA

If NS, note changes on RUA Amendment Form

R8j

Leak test current

S NS NA

R8k

Random check of vials

S NS NA

Chemicals

C2e

Peroxide formers and ethers dated

S NS NA

C8c

*Old ethers (Opened < six months)

S NS NA

C8d

*Outdated chemicals or bad conditioned containers in the lab

S NS NA

*If NS, request disposal

Controlled substances

CS8a

Inventory sheets current

S NS NA

CS8b

*Unwanted expired Controlled substances

S NS NA

*If NS, request disposal

WASTE DISPOSAL

LLRW

R8l

Properly segregated

S NS NA

R8m

Containers labeled

S NS NA

R8n

LLRW found in normal trash

S NS NA

R8o

Shielding adequate

S NS NA

Chemical

C8e

Tags attached to waste containers

S NS NA

C8f

*Waste stored under 60 days

S NS NA

*If NS request disposal

C8g

Containers closed and capped

S NS NA

Medical waste

B8e

Red bag/red autoclave bag used

S NS NA

B8f

Autoclave tape/temp. sensitive bag

S NS NA

B8g

Medical waste labeled

S NS NA

B8h

Sharps containers used properly (not overfilled)

S NS NA

B8i

Waste removed within 7 days

S NS NA

ADMINISTRATIVE

Behavioral (observation or evidence of)

Person

Location

G1e

Smoking

S NS NA

_________

___________

G1f

Eating/Drinking

S NS NA

_________

___________

G1g

Storage of food

S NS NA

_________

___________

G1h

Cosmetic Use

S NS NA

_________

___________

G1i

Mouth Pipetting

S NS NA

_________

___________

G1j

Housekeeping

S NS NA

_________

___________

Presence of Manuals and Documents

R1i

Rad-Safety Manual

S NS NA

B1h

Bio-Safety Manual

S NS NA

C1d

Chem-Safety Manual

S NS NA

CS1c

Controlled substances Manual

S NS NA

G1a

Newsletter

S NS NA

Posting

R2f

Title 17 Posting- Form (RH-2364)

S NS NA

G2a

Universal Hazard Notification

S NS NA

Housekeeping

F1f

Exits Unobstructed

S NS NA

F1g

Clear Stairway/Corridor

S NS NA

Injury and Illness Prevention Program (IIPP)

G1c

Departmental Safety Committee

S NS NA

G1d

Quarterly Meetings Held

S NS NA

Incidents involving:

R1c

RAM

S NS NA

B1c

Biological

S NS NA

C1e

Chemical

S NS NA

G1b

Other

S NS NA

If NS, obtain a copy of the report

EHS Specialist:

1/2/3/4, 1997

Lab Representative: