Principal Investigator Information
EH&S has developed a database of safety related information to enable us to manage our programs more efficiently and effectively. Complete this form only if you have not done so previously, or if there are any updates or changes to the information. Confidential information, such as home phone numbers, will only be shared with University Police, and will only be used to contact people in emergencies.
An email will be sent to ehsrap@ucsd.edu with the PI Information. If you have any questions, please call (858) 534-7651.
Your First Name :
Your Last Name :
Your Email Address:
PI Name :
Phone Number :
Department :
Cell Number :
Email Address :
Mail code :
Office Location :
UCID# :
Lab Building/Room :
Affiliate ID :
Previously at :
Admin. Contact :
Phone Number :
Email address :
Fax number :
Lab Contact :
Phone Number :
Email address :
Cell number :
UCID# :
Summary of Research :
Will your laboratory be using Biohazardous Materials? (Bacteria, Viruses, Recombinant DNA, Infectious Agents, Human or Primate Materials)
Yes
No
List Materials:
Will your laboratory be using radioactive materials / Machines?
Yes
No
List isotopes or machine type:
Will your laboratory be using compressed gases?
Yes
No
List gases:
Will your laboratory be using acutely toxic substances, carcinogens, or reproductive toxins or nano materials (beyond standard chemical hazards)?
Yes
No
List materials:
Will your lab be using Class 3B or Class 4 lasers in your research?
Yes
No
Will your laboratory be using Controlled Substances? (i.e. Ketamine, Pentobarbital, Buprenorphine)
Yes
No
Will your laboratory be using Select Agents (i.e. Conotoxins, Ricin, Tetrodotoxin, Coxiella burnetii)?
Yes
No
List materials: