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Hazard Clearance and Declaration


Introduction

The purpose of the Hazard Clearance and Declaration Form (a.k.a. Clean Sheet) is to make Physical Facilities (PF) personnel aware of the potential hazards that may exist in areas where they are requested to perform work. PF personnel are not expected to handle equipment such as fume hoods, refrigerators, freezers, furniture, or other laboratory accessories that may be dirty or contaminated with hazardous materials. It is the responsibility of the person making the work request (customer) to ensure that all surfaces have been properly cleaned and/or decontaminated if necessary before PF personnel arrive to perform work in the area. It is also the customer's responsibility to declare any unique hazards (e.g. electrical, physical) that may still remain in the area. The Hazard Clearance and Declaration Form facilitates the necessary communication between the customer and PF personnel.

The Hazard Clearance and Declaration Form will be initiated by PF personnel if there is a need to request more information about the potential hazards of an area, or it can be initiated by the customer at the time work is requested to lessen the potential for work delays. However, it is always the customer's responsibility to complete Section 1 of this form when asked to do so.


REM's Role

If radioisotopes have been used the form must be completed and Radiological and Environmental Management (REM) must be contacted (49-46371). Radioisotope use is the only circumstance where it is necessary to contact REM. If the customer properly decontaminates an area and declares the hazards that may still remain on the form, then it is not necessary for REM to get involved. However, if the customer or PF personnel need REM to provide a professional opinion about possible needs for more cleaning, analytical testing, or additional Personal Protective Equipment (PPE) requirements they can do so by contacting one of the following individuals:

Adam Krajicek
Hazardous Materials Manager
49-63072
arkrajicek@purdue.edu

Bob Golden
Biological Safety Officer
49-41496
rgolden@purdue.edu

Lila Albin
Senior Industrial Hygienist
49-40204
lcalbin@purdue.edu

Steve Gauger
Assistant Director
49-40238
sagauger@purdue.edu

Jim Schweitzer
Director, Radiation Safety Officer
49-42350
jfschweitzer@purdue.edu


Decommissioning and Cleaning

The following procedures must be completed by the customer before PF personnel perform services:

  • If radioisotopes were used, decontaminate all accessible surfaces and contact REM (49-6371) to verify that no contamination exists.
  • If biological agents were used, decontaminate all accessible surfaces with an appropriate disinfectant (e.g. 10% bleach solution). Indicate the type of decontamination procedures that were used in Section 1 of the Hazard Clearance and Declaration Form. Explain any stains or other evidences of spills that may still remain after cleaning has been performed. Contact REM (49-41496) if you have questions about proper decontamination procedures.
  • When requesting PF personnel to dispose of equipment, ensure that all surfaces have been cleaned and/or decontaminated if necessary. Explain any stains or other evidences of spills that may still remain after cleaning has been performed. Ensure that all hazard labels (e.g. Biohazard, Carcinogen) have been removed or defaced. The exception to this rule is for radioactive labels; REM will remove these labels once the equipment is confirmed to have no contamination.
  • Remove all chemical containers, beakers, test tubes, sharps, and all other potentially hazardous materials from the immediate area (e.g. remove chemicals from the hood before PF personnel arrive to work on the hood). Any additional hazards that may be present should be abated or clearly stated in Section 1 of this form if abatement is not possible.
  • Communicate all potential hazards and recommend appropriate personal protective equipment if necessary in Section 1 of this form. PF personnel will be able to perform their job more safely if they are aware of all hazards that are present.

 

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Last Modified: Wednesday, September 5, 2007
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