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Research Safety Chematix Change Request Forms
Chematix Laboratory Listing Request Form
Complete this form to have a laboratory listing inserted into Chematix.
Please enter the four digit building number (as designated by Facilities Management).
Please enter the room number for the lab location (one room number per request form).
Enter the faculty member's university email address.
Laboratory Supervisor Name
Laboratory Supervisor Email
Do previous laboratories listed in this same room need to be archived?
Select yes if all current laboratories in Chematix for the indicated room number should be archived.
Should the existing chemical inventory listing for this lab be transferred to the new listing?
Select yes if the new lab will inherit all of the existing chemical inventory from the lab listing it is replacing.
What is the status of chemical waste for this new lab listing?
No chemical waste issues related to this new lab listing
Chemical waste exists from previous occupants of this lab location, is labeled properly and has been submitted to ESD for pickup
Chemical waste exists from previous occupants of this lab location, is NOT labeled or needs other attention
Chemical waste being generated by new occupants; training on proper waste processing may be needed
Select the option that describes the status of chemical waste for the new lab listing.
Inspector Requesting Opening
Inspector Email Address
Please list email address you wish to receive copy of this request.
Leave this field blank
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1 + 0 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
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