APPLICATION TO HOUSE ANIMALS OUTSIDE A YARC- MANAGED FACILITY
PI
Protocol #
Species
Housing Location: Bldg.
Room
Key Card Access code ( if applicable)
1. Scientific Justification
2. Anticipated Use
Sporadic Use (typically animal present approximately
days per month)
Continual Use (typically one or more cages of animals will be housed in the location at most
times)
Maximum duration a given animal will be housed in the location
Average number of cages in the location at any given time
Maximum number of animals in the location at any given time
Will animals return to a YARC facility? Yes
No
3. Person(s) responsible for care of animals and emergency contact information
Staff member
Lab number
Cell phone or After Hours Number
4. Directions for completing the table below: Please describe the ability to monitor the environmental
parameters in the location of the housed animals.
Environmental Parameters
Can be
Assessed
Temperature (min/max and current)*
Humidity (min/max and current)*
Ventilation (HVAC, air exchanges and
relative pressure. This information
Required
Required
Can be Adjusted
Remote
Monitoring
Available
N/A
should be obtained from Facilities
Operations)
Illumination
Control of Light:Dark Cycle
Noise control (ability to buffer or be
isolated from equipment with a
constant or intermittent noise output)
N/A
*PI required to obtain IACUC-approved equipment
5. Will the animals be housed using YARC standards, including primary enclosure, bedding, water, food,
environmental enrichment? Yes
No
Describe if “no”
6. Husbandry services will be provided consistent with the Lab Housing SOPs (see below).
I confirm that the IACUC documents listed below will be followed:
 Lab Housing Intent Form
 Lab Housing SOP: Daily Health Checks
 Lab Housing SOP: Sanitation
 Lab Housing Daily and Weekly Log
7. Hazardous Agents:
Will animals housed in this location be exposed to any hazardous agents? Yes
No
If yes: A start-up meeting with representatives from OARS, YARC and EHS must occur prior to the
first animals being housed in the location.
8. Security and Access:
a. How are the room(s) and area secured:
b. How do you assure that only authorized personnel have access to animals under your care:
IACUC APPROVED EQUIPMENT
Vendor Information
Grainger: Clock Digital Hygrometer
Item # 3ZH92
124 Universal Dr..,
NORTH HAVEN, CT 06473-3630
Contact
http://www.grainger.com/product/EXTEC
H-Clock-Digital-Hygrometer3ZH92?nls=1&nlsit=0.8&ssf=2&searchQu
ery=3ZH92
Phone
1-800-GRAINGER
(472-4643)
(203) 777-2087