Move Manual: Attachment to Laboratory and Shop Move Manual

Facilities/Equipment Decontamination Clearance
(Sample Only - to print out a paper copy, download PDF found on Table of Contents page)
EH&S has assessed this location or equipment and determined that it can be released for reuse with no restrictions. This does not provide clearance for facilities or equipment containing lead paint or asbestos components.
Building
Room Number
Facility Description
Equipment
 
Check and sign where applicable:

Biohazardous Materials. When in use, biohazardous materials were handled in accordance with UC Berkeley policy and this area has been disinfected.
   checkbox Cleared By: _____________________ or checkbox N/A: ________________________
Radiological Materials. UC Berkeley’s EH&S Radiation Safety Team has cleared this area for unrestricted use. No regulated radioactive materials remain.
   checkbox Cleared By: _____________________ or checkbox N/A: ________________________
Laboratory Chemicals. Laboratory chemicals have been removed and disposed of in accordance with the UC Berkeley EH&S requirements. No regulated chemicals remain.
   checkbox Cleared By: _____________________ or checkbox N/A: ________________________
Controlled Substances. Laboratory chemicals have been removed and disposed of in accordance with the UC Berkeley EH&S requirements. No regulated chemicals remain.
   checkbox Cleared By: _____________________ or checkbox N/A: ________________________
 
EH&S Contact (please print):
Name:______________________________________________________ Date:_______________________
Phone Number: _______________________


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