INSTITUTIONAL BIOSAFETY COMMITTEE
UNIVERSITY OF NOTRE DAME
RESEARCH USING HAZARDOUS/INFECTIOUS MATERIALS
Principal Investigator:
Department:
Telephone:
Descriptive Title of Research:
New Protocol
Hazardous Agent
Renewal of protocol no: ________
Name
No Changes
Location of Use
Quantity
Biological Agents
Hazardous Chemicals or Drugs
Recombinant DNA
Study Conducted at Biosafety Level:
PERSONNEL PROPOSED FOR THIS PROJECT (Provide names and personnel training
information for all personnel including PI): For information on training or to schedule training,
contact Lisa Bognar Phillips at bognar.6@nd.edu in the Office of Risk Management and Safety.
Name
Training Date
Name
Training Date
OFFICE USE ONLY
IBC HazMat
Document 10/2014
Received by IBC
IBC Number
1
EXPERIMENTAL PROCEDURES
Describe the procedures that will involve the use of the material(s). Use additional pages as
necessary.
CONTROL PROCEDURES
Describe any additional controls not specified in the Laboratory Safety Manual that will be
employed to protect the individuals participating in this research. Use additional sheets as
necessary.
DECONTAMINATION AND DISPOSAL
Decontamination Procedures (surfaces, materials, instruments, equipment, etc):
Disposal Procedures (wastes and unused stock):
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EMERGENCY PROCEDURES
In the event of overt personnel exposure (inhalation, ingestion, inoculation):
In the event of environmental contamination (spill):
ANIMAL EXPERIMENTATION
All experimental procedures involving live vertebrate animals must be reviewed and approved
by the Institutional Animal Care and Use Committee (IACUC). Protocols need to be submitted
using the online protocol submission gateway, which can be accessed: or.nd.edu/researchcompliance, as paper copies are no longer accepted.
If animals are to be used in this research activity, provide the following information concerning
the safeguards that will be employed in conjunction with their use:
Personal Protective Equipment (gloves, respirator, approved clothing, booties, goggles, etc.):
Animal Care and Housing Requirements (containment cages, exposure procedures, bedding
change, dose preparation, cage cleaning, waste handling methods):
Facility Operational Procedures (access control, traffic patterns, decontamination procedures,
waste management, species isolation requirements):
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The principal investigator whose signature appears below has read and agrees to comply with
the current National Institutes of Health Guidelines for Research. He/She warrants that
employees, students, and associates working under their direction shall comply with the
guidelines.
Principal Investigator: ________
________________
(signature)
____________________________________________________
(date)
(name and title, type or print)
Please return this document to:
Office of Research Compliance
940 Grace Hall
University of Notre Dame
Notre Dame, Indiana 46556
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