JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Laboratory and Creative Spaces Placard Information Collection
Please fill out one of these forms for each lab or creative space that you are responsible for. It is important that this information be as correct as possible for each space.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What is the PrincipaI Investigator's (PI's) or Head Faculty member's name responsible for the lab/creative space? (last name, first initial)
Your answer
What department does the PI/Faculty member work in?
Your answer
What is the building that the lab is located in?
Choose
SRTC
SB1
CH
ENG
OND
FMH
If your building is not listed above, please enter it here:
Your answer
What is the room number of the lab/creative space?
Your answer
How many doors to the hallway does your space have?
One
Two
Other:
Clear selection
What types of chemical hazards are in the lab/creative space? (please select all that apply)
Explosives
Corrosives
Flammables/Pyrophorics
Acute Toxics
Oxidizers
Environmental Hazards
Carcinogens
Compressed Gases
What other types of special conditions exist in your lab/creative space? (please select all that apply)
Radioactive Materials
X-ray
Lasers
Biohazardous Materials
Other:
Please provide the cell phone number for the PI or Head Faculty member responsible for the lab space?
Your answer
Who is the Chair for your department?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Portland State University.
Report Abuse
Forms
