THE UNIVERSITY
of
T49
EDINBURGH
Estates & Buildings
■ PROJECT NAME & ID
ESTATE DEVELOPMENT
■ FILING REFERENCE
■ PROJECT MANAGER
T49 DECOMMISSIONING CERTIFICATE
INSERT NAME OF PROJECT
SECTION 1
1.1
Introduction
The purpose of this certificate is to confirm the clearance and decontamination of a room /
area within a building under the direction of the occupying School or College prior to
handover to Estates and Buildings for a building project (refurbishment or demolition).
The information provided will be used to help identify any remaining hazardous materials
within the facility and assess the associated risks. The completed form should be returned to
the Project Management team at the earliest opportunity.
1.2
Procedure
All relevant sections of the form must be completed fully and accurately by a responsible and
appropriate person from the School or College.


Section 3 is relevant for Individual rooms where radiation work has been carried out
Section 4 is relevant for all areas where chemical or biological hazards might exist

In sections 3 to 7, tick the boxes to confirm actions have been taken or score out if not
applicable
A single certificate can be completed for individual rooms or logical groupings of rooms (e.g.
along a lockable corridor) but each room in the group/area represented must be individually
decontaminated and cleared. On completion, undertake the following:
 Sign declaration on page 1
 Securely fix a signed copy of this form on the door of the room/area that it refers to
 Give original signed form to the Move Manager or Project Management Team for filing.
1.3
Declaration
I declare the entire room / area defined below has been fully cleared, decontaminated and
decommissioned in accordance with the actions indicated overleaf. Where this includes
potentially hazardous areas (e.g. laboratories, chemical stores), I declare these have been
left in a condition that any personnel may enter safely without need for any precautions
against chemical, biological or radioactive exposure. This includes removal of chemicals, oils
and other hazardous materials as required.
Building name & no
Room/area name & no
(as per building plans)
Responsible
person
signature and date
School and Role
Page 1 of 2
The University of Edinburgh is a charitable body, registered in Scotland, with registration number SC005336
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SECTION 2 - Area / Room details
2.1
Pre-decommissioning use of room/area
2.2
Reason for decommission
SECTION 3 - Radiation Protection
3.1
RP COP002 Protocol for the Decommissioning of Laboratories for Unsealed
Radioactive Work followed, checklist completed and copy attached.
3.2
Radiation Protection Unit has undertaken a final survey for each area where
Radiation work will no longer take place. List Survey Checklist Ref…………….
SECTION 4 - Cleaning, Removal & Decontamination or Identification of Hazard
4.1
Asbestos containing equipment (e.g. some incubators, ovens, etc) identified and
disposed of appropriately as agreed with the Asbestos Manager
4.2
All chemicals and biological or otherwise hazardous materials removed (including
from all benches, shelves, cupboards, drawer, fume cupboards & under sinks)
4.3
All laboratory coats cleaned and removed (check behind doors, in cupboards)
4.4
All hazard warning labels removed, including from doors, equipment, cupboards
4.5
All sinks and taps cleaned using adequate disinfectant to also disinfect drain traps
4.7
Any surfaces possibly contaminated by biological materials or chemicals
(including all benches and walls / floors / cupboards) decontaminated using
adequate disinfectant where appropriate
4.8
All microbiological safety cabinets fumigated and filters removed and appropriately
disposed of
4.9
All fume cupboards (and where appropriate ducts) decontaminated and filters
removed and appropriately disposed of
4.6
All equipment (e.g. electrical equipment, fridges, gas containers) decontaminated
and either appropriately disposed of or, if remaining in situ (e.g. fume cupboards)
clearly labelled as clean (with Name, Date and contact Tel no.)
SECTION 5 - Removal of all Equipment
5.1
Furniture Office has confirmed how any remaining furniture should be disposed of
5.2
Non-plumbed refrigerated equipment removed (by authorised specialist company)
5.3
IS has confirmed any phone handsets or AV remaining can be disposed of
5.4
E&B has confirmed remaining notice/white boards & blinds can be disposed of
5.6
Fire extinguishers removed by the Fire Safety in H&S Department
5.7
All remaining equipment and electrical goods (including leased items) have been
disconnected, are safe for disposal and can be disposed of
SECTION 6 - Removal of Waste / Personal Effects
6.1
All confidential waste has been removed and appropriately disposed of
6.2
Any remaining papers and books can be recycled
6.3
All remaining general waste can be recycled or disposed of safely
SECTION 7 - Security
7.1
All room keys collected and given to E&B Project Manager
7.2
Temporary security measures undertaken and in place
Page 2 of 2
The University of Edinburgh is a charitable body, registered in Scotland, with registration number SC005336