APPENDIX C - Facilities Management Hazard Notification Procedure/Form

1.0           Purpose                

These guidelines establish the procedures to be followed by both the requesting individual and all maintenance personnel concerned with a job request that may involve working in an area where hazardous materials are used. This includes Dow Science, Brooks, IT, Rowe, Wightman, and other buildings with laboratories and the associated lab equipment, chemicals, and utilities.

2.0           Responsibilities of the requester

2.1           An area within 4 feet of the work site should be cleared of all movable equipment and chemicals, cleaned, and completely decontaminated of all hazardous chemical residues. When work is needed inside a hood, all surfaces inside the hood must be cleaned.

2.2           Any equipment that cannot be moved should be made safe so as not to be a hazard. This protects the equipment as well as the worker.

2.3           To initiate the work or repairs, the requester must complete a Facilities Management Job Order, or Special Service Request (SSR), and a Hazard Notification Form for details. The Hazard Notification Form must be completed with as much detail as possible and a copy attached to the job order.

2.4           When the maintenance personnel arrive, the requester should use the Job Order and Hazard Notification Form as a guide to review the work, hazards, safety measures taken, and personal protective equipment required.

2.5           Maintain the work area in a safe condition while the maintenance is being performed.

2.6           Before work is resumed in the area, ensure that the maintenance is complete and it is safe to continue.

3.0           Responsibilities of maintenance personnel

3.1           Upon receipt of a job order for work in an area where hazardous materials are used, ensure there is a copy of the Hazard Notification Form attached to the job order.

3.2           Read the Hazard Notification Form and acquire any necessary personal protective equipment (PPE). The Warehouse carries most PPE items. If not available, contact the College of Science & Technology Safety Coordinator, or the Campus Safety Coordinator. See call list in Section 5.

3.3           Upon arrival at the work site, contact the requester. Review the Hazard Notification Form with him/her and have them answer any questions you may have.

3.4           Inspect the work site. Ensure that it is clean and decontaminated. Dampened multi-range pH paper can be used to determine whether any acids remain. If the equipment or the area is not clean, request that it be done at that time. If there is a difference of opinion as to whether the worksite is safe, follow the Call List in Section 5.

3.5           Appropriate personal protective equipment must be worn. Chemical resistant gloves should be worn when first inspection the area. Once it is determined there are no hazards, you may continue to work using the appropriate safety precautions. However, eye protection and a long-sleeved shirt and pants should be worn when working in a lab.

3.6           At any time during the job that other hazards are detected, including odors, notify the requester. Cease work until it is safe to continue.

3.7           Before leaving the work area, notify the requestor or the designated representative as to the status of the job. Be sure to inform the requestor when they are free to carry on normal operations.

4.0           Other information

4.1           In an emergency, if the person reporting the emergency is not knowledgeable of the hazards in the area, use the Call List at the end of this procedure.

4.2           If there is a chemical spill, it is the responsibility of the person who had the spill or the faculty member whose area it is to clean up the spill. Facilities Management personnel can only assist by calling for assistance and keeping others out of the area. Use the Call List below.

4.3           If there is a gas or strong odor in the air, leave the area and call someone on the Call List.

4.4           Dow Science Building-If there is work to be done in the dropped ceiling area of the building, and there is a concern that the area may not be safe, contact the College of Science & Technology Coordinator, day or night. If not available, contact the department chairperson for that section of the building. See Section 5.3 for names.

4.5           Dow Science building-If a ventilating fan shuts down or has to be shut down, see separate FM procedure entitled, “Dow Science Ventilation”.

4.6           If an incident occurs after hours, the Service Center or FM duty officer can assist in making the calls.

5.0           CALL LIST

5.1           Faculty members whose area it is. Names and telephone numbers are on the doors.

5.2           Jennifer Ehlert, College of Science & Technology Safety Coordinator; Phone 4189; Pager 612-1255

5.3           Dow Science Building Only:

Karl Lindfors, Chemistry Chair, Dow 268; phone 3981; Home phone 773-7881

Stan Hirschi, Physics Chair, Dow 203; Phone 3321; Home phone 772-5704

 5.4           Dow Science Building Only:

Chemistry Area- Jamie Stock (3378), LaurieEcker (3358), or Sharyl Majorski (3416) in the Chemistry Stock Room area, Rm. 143

Physics Area- Chuck Norisez (3397), Room 206.

5.5           Jon Kujat, Campus Safety Coordinator, Smith 103; Phone 3154; Home Phone 517-772-8924 

5.6           Earl Morrow, Director, Facilities Operations, CSB 215; Phone 6553. Home phone 773-6440

HAZARD NOTIFICATION

BUILDING:_________________________                 Room_____________                       Date_________________

Requester:____________________________________________________________________________________                                         Please Print

Detailed description of the job to be done or the repair required:_________________________________  

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Hazards in the immediate work area and the surrounding area, as appropriate (check all that apply): 

______  Corrosives             ______  Flammable                            ______  Oxidizers               ______  Mercury

______  Highly Toxic         ______  Pressurized Gas                   ______  Carcinogen           ______  Radiation

_____  Biohazard              ______  High Temperatures                ______ HighPressures            

______  High Voltage         ______  Mechanical Energy              ______  Apparatus Under Vacuum

Describe any chemical and/or physical hazards that may be present:______________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Describe any odors of materials that may be present:__________________________________________________

____________________________________________________________________________________________

Action taken to clean and decontaminate the work site:________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Personal Protective Equipment required by maintenance personnel:______________________________________

___________________________________________________________________________________________

___________________________________________________________________________________________

To the best of my knowledge, the area around which the work will be done has been cleaned and any chemical hazards removed.

___________________________________________________________________________________________

Requester’s Signature                                                                        Date

___________________________________________________________________________________________

FM Employee’s Signature                                                                  Date