May 2018
Visitor/Volunteer Name:
Visitor/Volunteer’s Signature:
Affiliation (if any):
Date Completed:
Sponsor’s Name:
Sponsor’s Signature:
Checklist for Technical Areas
(for activities beyond mere observation in Laboratories, Shops, Studios, Operations, Support
Services areas, etc.)
Instructions:
Sponsor: If you plan to have a visitor or volunteer participate in activities in a technical area such as a laboratory, shop, studio,
operational areas, etc. (e.g. places where chemicals or equipment are used) then complete this form prior to the start of their
participation. Review the Required Knowledge Areas and associated Responsibilities that apply to their potential participation with
your visitor/volunteer. Mark the ‘Yes’ check box once you have completed the review of responsibilities with your visitor/volunteer (If it
does not apply, mark the ‘NA’ box for not applicable). When the checklist is complete, be sure to retain in your records.
Required Knowledge
Areas (if applicable)
Yes
NA
Responsibilities Review with your visitor/volunteer those that apply
Laboratory Safe
Practices

Review the SCU Laboratory Rules and established Department or Laboratory-specific practices:
EHS Website Laboratory and Shop Safety
Shop Safety
Ensure your visitor/volunteer understands the access, training and supervision requirements for
working in your shop location.
MSDS and Chemical
Inventory Database
Ensure that your visitor/volunteer knows how to obtain chemical information from MSDSs and
how to access MSDSs online: EHS Website Laboratory and Shop Safety
Hazardous Materials
Review the use and storage procedures for your area such as: secondary containment, labeling,
segregation, chemical ordering and inventory, etc. Review safe handling procedures for
flammable liquids, such as bonding and grounding, proper storage, secondary containment, area
limits, etc. EHS Website Laboratory and Shop Safety
NOTE: Any use of high-hazard chemicals (peroxide formers, pyrophorics, water reactives,
explosives, highly toxic chemicals, etc.) by your visitor/volunteer must have prior approval of the
Department Chair or Dean. Visitor/volunteers should not order or bring chemicals on campus
without prior approval from SCU EHS.
Waste
Review the types of waste generated in the area (hazardous, bio-hazardous, sharps, radioactive,
medical, universal, etc.). Ensure your visitor/volunteer understands the waste handling and
disposal procedures for each, including waste streams and waste containers, labeling, storage
requirements, etc. EHS Website Laboratory and Shop Safety
PPE


Provide training on the use, care, and limits of personal protective equipment used in the area.
NOTE: Visitors/volunteers are not authorized to be in areas or do activities requiring
respiratory protection.
Emergency
Procedures
Show where your area’s emergency evacuation map is (found in hallways/corridors). Verify
visitor/volunteer knows where your building exits are and the evacuation routes (at least two) to
take in an emergency. Show location of your evacuation assembly point: SCU Campus Safety
Website
Review and check ‘Yes’ to those that apply once you have reviewed the listed Responsibilities with your visitor/volunteer. Check NA
for those that are not applicable.
Visitor/Volunteer EHS Orientation
Checklist for Technical Work Areas
May 2018
Required
Knowledge Areas (if
applicable)
Yes
NA
Responsibilities Review with your visitor/volunteer those that apply
Emergency
Reporting
Ensure that your visitor/volunteer knows how to contact emergency responders (SCU Campus
Safety extension x4444 or 408-554-4444 or 911) during or after work hours.
Eyewashes/Showers
Locate the nearest safety showers/eyewashes for your visitor/volunteer and describe the use of
them, for example, rinse for a minimum of 15 minutes.
Spills
Ensure that your visitor/volunteer knows to contact you or other designated personnel in case of a
spill. NOTE: Visitors/ volunteers are not authorized to clean up spills.
Biosafety and
Bloodborne
Pathogens
Ensure your visitor/volunteer knows that there are Bloodborne Pathogens or other Biosafety
sources in the area and how to be safe in the work space. NOTE: Visitors/volunteers are not
authorized to perform activities with Bloodborne Pathogens or other BSL 2 materials.
Radiation Safety
Ensure your visitor/volunteer knows that there are Radiation sources in the area and how to be
safe in the work space. NOTE: Visitors/volunteers are not authorized to perform activities with
radioactive materials or X-ray generating equipment.
Compressed
Gases/Cryogenics
Review the safe use of compressed gases and cryogenic materials. NOTE: Visitors/volunteers
are not authorized to perform activities on gas or cryogenic distribution systems.
Fume Hoods
Ensure that your visitor/volunteer understands the use of laboratory chemical fume hoods and
their proper use
Equipment/Tool
Safety
Ensure that you have reviewed the operating instructions for applicable equipment and tools
(such as saws, drill presses, grinders, etc.) and provided training on safe operation of the
equipment and tools with your visitor/volunteer.
Laser Safety
Ensure your visitor/volunteer knows that there is a laser in the area and how to be safe in the
work space. NOTE: Visitors/volunteers are not authorized to operate lasers without SCU EHS
approval.
Other Restricted
Activities
Ensure your visitor/volunteer knows that the following are prohibited: Electrical work involving
high voltage electrical equipment, electrical circuits, and electrical panels greater than or equal to
50 volts; perform lock-out and tag-out on equipment; work at heights of over 6 feet where no fall
protection is in place; work with tools that can create a fire danger such as welding equipment;
operate powered lift equipment, e.g. forklift, pallet jack, scissor lift; apply pesticides; and
supervise the operations of contractors/students/employees.
Other (indicate any
other training that
should be
documented)
Document training here:
Other (indicate any
other training that
should be
documented)
Document training here:
Other (indicate any
other training that
should be
documented)
Document training here:
When complete, retain for your records.
Visitor/Volunteer EHS Orientation
Checklist for Technical Work Areas