If your lab is planning to close, please fill out this Lab Close-Out Survey. Submitter Information: Full Name * Email Address * Phone Number * Are you the Principal Investigator whose lab is closing? * Yes No If you answered "No" to the previous question, please provide the name of the PI whose lab is closing. * 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 When do you expect to begin and finish the close-out process? Begin Date * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20252026 Finish Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20252026 To which school and department(s) do you belong? School * Natural Sciences Engineering Social Sciences, Humanities and Arts Primary Division * Secondary Division Please list the space(s) the lab will be vacating. Lab Location(s) * What hazardous materials will be removed? Mark all that apply. Animals Biologicals Chemicals Controlled Substances Cylinders Equipment using electricity Lasers Radioactive Materials or Radiation Producing Machines Other (please specify) What hazardous materials will be removed? Mark all that apply. Other (please specify) Please provide the Safety Specialist team with a tentative timeline of the lab closure.This is optional. Choose a file to upload. Files must be less than 5 MB.Allowed file types: gif jpg jpeg png pdf doc docx xlsx. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
