Environmental Health and Safety

Biosafety Level 2 Signage

Biosafety Level 2 Signage

Person Completing This form

CONTACT INFORMATION

Name: *

Email *

Phone: *

Principal Investigator

CONTACT INFORMATION

Name: *

Campus Building *

Room Number: *

Department: *

Work/Campus Phone: *

24 Hour Emergency Phone (Home/Cell): *

Emergency Contact #1

CONTACT INFORMATION

Name: *

Campus Office Building * Campus Office Building

Room Number: *

Department: *

24 Hour Emergency Phone (Home/Cell): *

Emergency Contact #2

CONTACT INFORMATION

Name: *

Campus Office Building * Campus Office Building

Room Number *

Department: *

24 Hour Emergency Phone (Home/Cell): *

Hazard Identification:

List all biological agents used or stored in the identified space

Is a UV light source present?

Location sign to be place

Building where sign is to be installed * Building where sign is to be installed

Lab/Room number where sign is to be installed *

Sending

If you are human, leave this field blank.

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