Laboratory Closures

Lab Close-out Information

Responses to the questions below will help Lab Portal guide you through the lab close-out process.

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* Submitter Contact Information:

Full Name *

Email Address *

Phone Number

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* Are you the Principal Investigator whose lab is closing?

Yes

No

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* If you answered 'No' to the previous question, please provide the name of the PI whose lab is closing.

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* Is there another point of contact, other than yourself, that will be involved in the close-out (i.e. Lab Manager, department representative)?

Full Name

Email Address

Phone Number

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* When do you expect to begin and finish the closeout process?

Begin Date

Date

Finish Date

Date

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* To which department(s) do you belong?

Primary Appointment:

Division:

Secondary Appointment:

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* Please list the building(s) and room number(s) that you will be vacating.

Lab Location

Lab Location

Lab Location

Lab Location

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* What hazardous materials will be removed? Mark all that apply.

Animals

Biologicals

Chemicals

Controlled Substances

Cylinders

Equipment using electricity

Lasers

Radioactives

Other (please specify)

Question Title

* OPTIONAL: Please provide EH&S Lab Portal with a tentative timeline of the upcoming lab close-out (.pdf, .doc, or .docx files only).

PDF, DOCX, DOC file types only.

Use these linked documents to assist in the lab close-out process.

Lab Closeout Master Checklist
Lab Equipment Decontamination Form