CHP2 Registration Request

1. Enter your first name (as in University records). *

2. Enter your last name (as in University records) *

3. Enter date (mm/dd/yyyy) you completed the CHP1 online exercise. *

4. Enter date (mm/dd/yyyy) you completed the PPE online exercise. *

7. Choose the best response for a CHP2 meeting time for you. * (Chose "nothing here is possible" if all dates are in the past, or if you are unavailable for any shown here.)

6. Enter your Purdue career account "alias" (username). * Look it up in the University records at https://www.itap.purdue.edu/directory/

7. What is the Dept of your work/research supervisor? * (Learn/use the accepted abbreviation, e.g. CHM, CHE, MCMP, BIOL, VTH....)

8. Your classification: choose one of these. *

9. Name of the professor or administrative staff member who is your supervisor: * (Learn the correct spelling, give first name and last name.)

10. In which building(s) will your work take place? Please use accepted abbreviations. * (Campus map at <http://www.purdue.edu/campus_map/> shows accepted abbreviations.)

11.a Will you work with a chemical hood ("fume" hood)? *

yes
no

11.b Will you work with a biosafety cabinet or other laminar flow cabinet? *

yes
no

11.c Will you use a rotary evapoator? *

yes
no

11.d Will you be around pressures below 20 torr? * (for example if your or others in your room are using rotary evaporation...)

yes
no

11.e Will you be around pressures above 1.5 atm? * (for example if you or others in your room are using any compressed gases)

yes
no

11.f Will you be working with (handling) any vertebrate animals? *

yes
no

11.g Will you be loading or unloading an autoclave? *

yes
no

11.h Will you work directly with halogenated solvents? * e.g. dichloromethane, chloroform, trichloroethane, .....?

yes
no

11.i Will you work with radioisotopes or radiation producing devices? * Here, "radiation producing" means "ionizing radiation producing."

yes
no

11.j Will you be involved in glassblowing, torchcutting, or welding? *

yes
no

11.k Will you be working with or working around any chemical carcingoens or other exposure circumstances regarded as carcinogenic? *

yes
no

11.l Will your work be with or near exposed beam lasers? *

yes
no

11.m Toxic metals or metal compounds -- working them with or working in same room as others who are working with them? *

yes
no

11.n Will pipetting be a part of your activities in any week of any month during your research? *

yes
no

11.o Will your work include high speed (approx 14,000 - 20,000 rpm) or ultraspeed (up to 110,000 rpm) centrifugation)? * (Bench top units which spin at <14,000 do not have the same hazards as most hig and ultras.)

yes
no

11.p Will you be near to or using liquefied gas(es) ("cryogens," most commonly liquid nitrogen)? *

yes
no

11.q Will you work with exposed energized electrical components of > 50 V? *

yes
no

11.r Will you work with human cells, fluids, or tissue? *

yes
no

11.s Will your work involve other biological agents other than human cells/tissue/fluids? * viruses, bacteria, fungus.....

yes
no

12. List compressed gases with which you will or might be working. * The most common are nitrogen, argon, hydrogen, air, oxygen, helium, and carbon dioxide.

13. Name any/all halogentaed solvents with which you will or might be working. * Dichloromethane (maybe called "DCM," also known as methylene chloride) is most common. Chloroform is also quite common.

14. What flammable liquids might you, or will you, be using? * MANY common ones. Diethyl ether, THF, acetone, acetonitrile, ethyl acetate, all alkanes to about c10 and all alkanols to about c7...

15. Describe what you will be doing in your own words. * Include what you think might be dangerous, if anything. Write a few sentences at least.