Sample
Safety Contract – Lab Notebook Page 1
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Exp #: One |
Experiment/Subject: Laboratory Safety Contract |
Title Page |
Date: / /12 |
Page 01 |
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Name: |
Lab Partner: |
Course: CHM 1025 C |
Section # |
Name: _________________________ Email: ____________________________
Address: _______________________ 2nd Email: _________________________
_______________________________ Phone #: __________________________
__________________ Cell Phone: ________________________
Course: CHM 1025C
Section #: __________
Professor: John
T. Taylor
I,
____________________________, have watched the ACS Laboratory Safety Film. I
have read the different sets of Safety Rules from various colleges provided by
my instructor. I have synthesized from these rules and the safety film a list
of at least 20 rules written in this Laboratory Notebook which I agree to abide
by during all
formal laboratory activities and experiences in FSCJ North Campus’s D-204
Chemistry Lab. I agree to wear proper safety glass at all times during lab
activity, regardless if I, myself, am not currently performing any activity. I
agree to lose points on my current lab if I am not wearing these safety
glasses. I understand that protective aprons, gloves and lab coats are available
at my option to use during formal lab activity. I have sketched in this
laboratory notebook, the layout of the North Campus Chemistry Lab D-204 and
have noted the placement of all safety features, equipment and supplies in this
Post Lab Safety Report.
Signed:
_______________________Date:________________
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Signature: |
Date: |
Witness/TA: |
Date: |