Summary: Non-UCSB MRL Laboratory Facility User Safety Training Documentation Form
This form is required for all non-UCSB people, including industrial users and users from other
universities, working in MRL laboratory facilities.
Name: _________________________________ Job Title: ________________________________
Company or Institution: ______________________________ E-mail address: ___________________________
Non-UC Supervisor's Name: ____________________________ Non-UC Supervisor's Title:__________________
MRL Facilities where work is to be done ____________________________________________________
All users of MRL Facilities must understand and comply with the following. Check each to indicate that
you understand and agree to comply.
_____ Everyone working in MRL Laboratory Facilities is required to work in a safe and professional manner and to follow
standard prudent laboratory practice.
_____ In any emergency where there is injury to any person or threat to any structures, call 9-911 first and then notify the
Department Safety Representative (DSR). (See below for contact information.)
_____ Any time the building fire alarm sounds, everyone in the building must evacuate the building immediately and
assemble at the southwest corner of Engineering II. This is the MRL's Emergency Assembly Point.
_____ During a significant earthquake, everyone in the building should stand in door frames or take cover under desks until
the quake is over. Then quickly leave the building and go to the Emergency Assembly Point.
_____ Smoking is not allowed inside or near any UCSB building.
_____ Everyone has the right and obligation to report any unsafe situation at UC. Such reports may be made directly to the
supervisor or anonymously to the DSR or alternate. A Hazard Reporting Form is available at the Safety Bulletin