{"id":2064,"date":"2026-07-13T11:51:20","date_gmt":"2026-07-13T15:51:20","guid":{"rendered":"https:\/\/www.umes.edu\/ehscopy\/?page_id=2064"},"modified":"2026-07-28T11:26:39","modified_gmt":"2026-07-28T15:26:39","slug":"laboratory-registration-modification-request-form","status":"publish","type":"page","link":"https:\/\/www.umes.edu\/ehs\/laboratory-registration-modification-request-form\/","title":{"rendered":"Laboratory Lifecycle assessment Request Form"},"content":{"rendered":"\n<div class=\"forminator-guttenberg\"><div class=\"forminator-ui forminator-custom-form forminator-custom-form-1467 forminator-design--default forminator-enclosed forminator_ajax\" data-forminator-render=\"0\" data-form=\"forminator-module-1467\" data-uid=\"6a8926be47fee\"><br\/><\/div><form\r\n\t\t\t\tid=\"forminator-module-1467\"\r\n\t\t\t\tclass=\"forminator-ui forminator-custom-form forminator-custom-form-1467 forminator-design--default forminator-enclosed forminator_ajax\"\r\n\t\t\t\tmethod=\"post\"\r\n\t\t\t\tdata-forminator-render=\"0\"\r\n\t\t\t\tdata-form-id=\"1467\"\r\n\t\t\t\t data-color-option=\"default\" data-design=\"default\" data-grid=\"enclosed\" style=\"display: none;\"\r\n\t\t\t\tdata-uid=\"6a8926be47fee\"\r\n\t\t\t><div role=\"alert\" aria-live=\"polite\" class=\"forminator-response-message forminator-error\" aria-hidden=\"true\"><\/div><div class=\"forminator-row\"><div id=\"select-1\" class=\"forminator-field-select forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-form-1467__field--select-1_6a8926be47fee\" id=\"forminator-form-1467__field--select-1_6a8926be47fee-label\" class=\"forminator-label\">Purpose for Request <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-1467__field--select-1_6a8926be47fee\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-1\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Select one of the following\" data-search=\"false\" data-search-placeholder=\"Select one of the following\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-1467__field--select-1_6a8926be47fee-label\"><option value=\"\"  >Select one of the following<\/option><option value=\"one\"  data-calculation=\"0\">New Laboratory<\/option><option value=\"two\"  data-calculation=\"0\">Laboratory Modification<\/option><option value=\"Relocation-of-existing-Laboratory\"  data-calculation=\"0\">Relocation of existing Laboratory<\/option><option value=\"Repurposing-of-Laboratory\"  data-calculation=\"0\">Repurposing of existing Laboratory<\/option><option value=\"Decomissioning\"  data-calculation=\"0\">Decommissioning<\/option><option value=\"Closeout\"  data-calculation=\"0\">Closeout<\/option><\/select><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-21\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-21_6a8926be47fee\" id=\"forminator-field-text-21_6a8926be47fee-label\" class=\"forminator-label\">Modification Details (for Modification Requests)<\/label><input type=\"text\" name=\"text-21\" value=\"\" placeholder=\"\" id=\"forminator-field-text-21_6a8926be47fee\" class=\"forminator-input forminator-name--field\" data-required=\"\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-2\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-1467__field--select-2_6a8926be47fee\" id=\"forminator-form-1467__field--select-2_6a8926be47fee-label\" class=\"forminator-label\">Type of laboratory <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-1467__field--select-2_6a8926be47fee\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-2\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Select one of the following\" data-search=\"false\" data-search-placeholder=\"Select one of the following\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-1467__field--select-2_6a8926be47fee-label\"><option value=\"\"  >Select one of the following<\/option><option value=\"one\"  data-calculation=\"0\">Teaching<\/option><option value=\"two\"  data-calculation=\"0\">Research<\/option><option value=\"Clinical\"  data-calculation=\"0\">Clinical<\/option><option value=\"Shared-Space\"  data-calculation=\"0\">Shared Space<\/option><option value=\"Field\"  data-calculation=\"0\">Field<\/option><\/select><\/div><\/div><div id=\"text-4\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-4_6a8926be47fee\" id=\"forminator-field-text-4_6a8926be47fee-label\" class=\"forminator-label\">Lab Location (Building\/Rm): <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-4\" value=\"\" placeholder=\"E.g. text placeholder\" id=\"forminator-field-text-4_6a8926be47fee\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"name-1\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-1_6a8926be47fee\" id=\"forminator-field-name-1_6a8926be47fee-label\" class=\"forminator-label\">Principal Investigator (PI): Last Name: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-1\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-1_6a8926be47fee\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><div id=\"name-2\" class=\"forminator-field-name forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-name-2_6a8926be47fee\" id=\"forminator-field-name-2_6a8926be47fee-label\" class=\"forminator-label\">First name: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"name-2\" value=\"\" placeholder=\"E.g. John Doe\" id=\"forminator-field-name-2_6a8926be47fee\" class=\"forminator-input forminator-name--field\" aria-required=\"true\" autocomplete=\"name\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"phone-1\" class=\"forminator-field-phone forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-phone-1_6a8926be47fee\" id=\"forminator-field-phone-1_6a8926be47fee-label\" class=\"forminator-label\">Phone Number: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"phone-1\" value=\"\" placeholder=\"E.g. +1 300 400 5000\" id=\"forminator-field-phone-1_6a8926be47fee\" class=\"forminator-input forminator-field--phone\" data-required=\"1\" aria-required=\"true\" autocomplete=\"off\" \/><\/div><\/div><div id=\"email-1\" class=\"forminator-field-email forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-email-1_6a8926be47fee\" id=\"forminator-field-email-1_6a8926be47fee-label\" class=\"forminator-label\">E-mail: <span class=\"forminator-required\">*<\/span><\/label><input type=\"email\" name=\"email-1\" value=\"\" placeholder=\"E.g. john@doe.com\" id=\"forminator-field-email-1_6a8926be47fee\" class=\"forminator-input forminator-email--field\" data-required=\"1\" aria-required=\"true\" autocomplete=\"email\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-1\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-1_6a8926be47fee\" id=\"forminator-field-text-1_6a8926be47fee-label\" class=\"forminator-label\">Department <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-1\" value=\"\" placeholder=\"E.g. text placeholder\" id=\"forminator-field-text-1_6a8926be47fee\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><div id=\"text-2\" class=\"forminator-field-text forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-2_6a8926be47fee\" id=\"forminator-field-text-2_6a8926be47fee-label\" class=\"forminator-label\">Department Chair: <span class=\"forminator-required\">*<\/span><\/label><input type=\"text\" name=\"text-2\" value=\"\" placeholder=\"E.g. text placeholder\" id=\"forminator-field-text-2_6a8926be47fee\" class=\"forminator-input forminator-name--field\" data-required=\"1\" \/><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"group-1\" class=\"forminator-field-group forminator-col forminator-col-12 \"><label class=\"forminator-label forminator-repeater-label\">Comittee Approval (Select all that apply using dropdown menu)<\/label><div class=\"forminator-all-group-copies forminator-repeater-field\"><div class=\"forminator-grouped-fields\" data-options=\"{&quot;is_repeater&quot;:true,&quot;min_type&quot;:&quot;custom&quot;,&quot;max_type&quot;:&quot;custom&quot;,&quot;min&quot;:4,&quot;max&quot;:9223372036854775807,&quot;add_text&quot;:&quot;Add item&quot;,&quot;remove_text&quot;:&quot;Remove item&quot;,&quot;action_element_type&quot;:&quot;button&quot;}\"><div class=\"forminator-row\"><div id=\"select-6\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-1467__field--select-6_6a8926be47fee\" id=\"forminator-form-1467__field--select-6_6a8926be47fee-label\" class=\"forminator-label\">Committee(s)<\/label><select  id=\"forminator-form-1467__field--select-6_6a8926be47fee\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"\" name=\"select-6\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"\" data-search=\"false\" data-search-placeholder=\"\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-1467__field--select-6_6a8926be47fee-label\"><option value=\"Select-one\"  data-calculation=\"0\">Select one<\/option><option value=\"one\"  data-calculation=\"0\">Institutional Animal Care and Use Committee (IACUC)<\/option><option value=\"two\"  data-calculation=\"0\">Institutional Review Board (IRB)<\/option><option value=\"Institutional-Biosafety-Committee-(IBC\"  data-calculation=\"0\">Institutional Biosafety Committee (IBC<\/option><option value=\"Radiation-Safety-Committee-(RSC)\"  data-calculation=\"0\">Radiation Safety Committee (RSC)<\/option><\/select><\/div><\/div><div id=\"date-5\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-5-picker_6a8926be47fee\" id=\"forminator-field-date-5-picker_6a8926be47fee-label\" class=\"forminator-label\">Date of Approval<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-5\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-5-picker_6a8926be47fee\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row forminator-action-buttons\"><div class=\"forminator-col forminator-col-12\"><input type=\"button\" value=\"Add item\" class=\"forminator-repeater-action-button forminator-repeater-add\" \/><input type=\"button\" value=\"Remove item\" class=\"forminator-repeater-action-button forminator-repeater-remove\" \/><\/div><\/div><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-3\" class=\"forminator-field-checkbox forminator-col forminator-col-6 \"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-3-6a8926be47fee-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-3-6a8926be47fee-label\" class=\"forminator-label\">Hazard Assessment(s) Completed (Select all that apply) <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-3-1-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-1-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Biological Hazard ID and Risk Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"one\" id=\"forminator-field-checkbox-3-1-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-1-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Biological Hazard ID and Risk Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-2-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-2-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Chemical Hazard ID and Risk Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"two\" id=\"forminator-field-checkbox-3-2-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-2-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Chemical Hazard ID and Risk Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-3-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-3-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Environmental Impact Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Radiation-Safety-Assessment\" id=\"forminator-field-checkbox-3-3-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-3-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Environmental Impact Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-4-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-4-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Ergonomic Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Er\" id=\"forminator-field-checkbox-3-4-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-4-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Ergonomic Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-5-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-5-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Laser Safety Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Laser-Safety-Assessment\" id=\"forminator-field-checkbox-3-5-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-5-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Laser Safety Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-6-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-6-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Radiation Safety Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Radiation-Safety-Assessment\" id=\"forminator-field-checkbox-3-6-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-6-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Radiation Safety Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-7-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-7-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Process hazard Analysis\/HAZOP\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Process-hazard-Analysis-HAZOP\" id=\"forminator-field-checkbox-3-7-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-7-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Process hazard Analysis\/HAZOP<\/span><\/label><label id=\"forminator-field-checkbox-3-8-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-8-6a8926be47fee\" class=\"forminator-checkbox\" title=\"PPE Asssessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"PPE-Asssessment\" id=\"forminator-field-checkbox-3-8-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-8-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">PPE Asssessment<\/span><\/label><label id=\"forminator-field-checkbox-3-9-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-9-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Medical Safety Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Medical-Safety-Assessment\" id=\"forminator-field-checkbox-3-9-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-9-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Medical Safety Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-10-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-10-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Fire and Life Safety Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Fire-and-Life-Safety-Assessment\" id=\"forminator-field-checkbox-3-10-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-10-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Fire and Life Safety Assessment<\/span><\/label><label id=\"forminator-field-checkbox-3-11-6a8926be47fee-label\" for=\"forminator-field-checkbox-3-11-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Laboratory Equipment Assessment\"><input type=\"checkbox\" name=\"checkbox-3[]\" value=\"Laboratory-Equipment-Assessment\" id=\"forminator-field-checkbox-3-11-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-3-11-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Laboratory Equipment Assessment<\/span><\/label><\/div><\/div><div id=\"date-1\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-1-picker_6a8926be47fee\" id=\"forminator-field-date-1-picker_6a8926be47fee-label\" class=\"forminator-label\">Most Recent Date of Assessment <span class=\"forminator-required\">*<\/span><\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-1\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-1-picker_6a8926be47fee\" class=\"forminator-input forminator-datepicker\" data-required=\"1\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"checkbox-1\" class=\"forminator-field-checkbox forminator-col forminator-col-12 \"><div role=\"group\" class=\"forminator-field required\" aria-labelledby=\"forminator-checkbox-group-forminator-field-checkbox-1-6a8926be47fee-label\"><span id=\"forminator-checkbox-group-forminator-field-checkbox-1-6a8926be47fee-label\" class=\"forminator-label\">Hazard categories (Check all that apply): <span class=\"forminator-required\">*<\/span><\/span><label id=\"forminator-field-checkbox-1-1-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-1-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Animals\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Animal-materials\" id=\"forminator-field-checkbox-1-1-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-1-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Animals<\/span><\/label><label id=\"forminator-field-checkbox-1-2-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-2-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Biological Material ( Toxins, Microorganisms, Pathogens, agents, etc)\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"two\" id=\"forminator-field-checkbox-1-2-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-2-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Biological Material ( Toxins, Microorganisms, Pathogens, agents, etc)<\/span><\/label><label id=\"forminator-field-checkbox-1-3-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-3-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Hazardous Chemicals\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Hazardous Chemicals\" id=\"forminator-field-checkbox-1-3-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-3-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Hazardous Chemicals<\/span><\/label><label id=\"forminator-field-checkbox-1-4-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-4-6a8926be47fee\" class=\"forminator-checkbox\" title=\"General Laboratory Chemicals (non-hazardous\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"one\" id=\"forminator-field-checkbox-1-4-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-4-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">General Laboratory Chemicals (non-hazardous<\/span><\/label><label id=\"forminator-field-checkbox-1-5-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-5-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Cryogens\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Cryogens\" id=\"forminator-field-checkbox-1-5-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-5-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Cryogens<\/span><\/label><label id=\"forminator-field-checkbox-1-6-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-6-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Human material (blood, tissues, bodily fluids,  cell culture, etc)\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Human-materials\" id=\"forminator-field-checkbox-1-6-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-6-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Human material (blood, tissues, bodily fluids,  cell culture, etc)<\/span><\/label><label id=\"forminator-field-checkbox-1-7-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-7-6a8926be47fee\" class=\"forminator-checkbox\" title=\"High-pressure systems\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"High-pressure-systems\" id=\"forminator-field-checkbox-1-7-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-7-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">High-pressure systems<\/span><\/label><label id=\"forminator-field-checkbox-1-8-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-8-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Laser\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Laser\" id=\"forminator-field-checkbox-1-8-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-8-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Laser<\/span><\/label><label id=\"forminator-field-checkbox-1-9-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-9-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Radioactive materials\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Radiation\" id=\"forminator-field-checkbox-1-9-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-9-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Radioactive materials<\/span><\/label><label id=\"forminator-field-checkbox-1-10-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-10-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Radiation-Producing equipment\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Electrical\" id=\"forminator-field-checkbox-1-10-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-10-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Radiation-Producing equipment<\/span><\/label><label id=\"forminator-field-checkbox-1-11-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-11-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Non-ionizing radiation\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Mechanical\" id=\"forminator-field-checkbox-1-11-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-11-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Non-ionizing radiation<\/span><\/label><label id=\"forminator-field-checkbox-1-12-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-12-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Recombinant DNA\/Synthetic Nucleic Acids\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Recombinant-DNA-Synthetic-Nucleic-Acids\" id=\"forminator-field-checkbox-1-12-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-12-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Recombinant DNA\/Synthetic Nucleic Acids<\/span><\/label><label id=\"forminator-field-checkbox-1-13-6a8926be47fee-label\" for=\"forminator-field-checkbox-1-13-6a8926be47fee\" class=\"forminator-checkbox\" title=\"Compressed gases\"><input type=\"checkbox\" name=\"checkbox-1[]\" value=\"Compressed-gases\" id=\"forminator-field-checkbox-1-13-6a8926be47fee\" aria-labelledby=\"forminator-field-checkbox-1-13-6a8926be47fee-label\" data-calculation=\"0\"   data-hidden-behavior=\"zero\"\/><span class=\"forminator-checkbox-box\" aria-hidden=\"true\"><\/span><span class=\"forminator-checkbox-label\">Compressed gases<\/span><\/label><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"text-22\" class=\"forminator-field-text forminator-col forminator-col-12 \"><div class=\"forminator-field\"><label for=\"forminator-field-text-22_6a8926be47fee\" id=\"forminator-field-text-22_6a8926be47fee-label\" class=\"forminator-label\">Specialized equipment (List all that apply)<\/label><input type=\"text\" name=\"text-22\" value=\"\" placeholder=\"\" id=\"forminator-field-text-22_6a8926be47fee\" class=\"forminator-input forminator-name--field\" data-required=\"\" aria-describedby=\"forminator-field-text-22_6a8926be47fee-description\" \/><span id=\"forminator-field-text-22_6a8926be47fee-description\" class=\"forminator-description\">example: Biosafety cabinet, fume hood, x-ray equipment, laser, cyrogens, fire cabinet, corrosive cabinet, NMR, etc)<\/span><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-4\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-1467__field--select-4_6a8926be47fee\" id=\"forminator-form-1467__field--select-4_6a8926be47fee-label\" class=\"forminator-label\">SOP&#039;s developed and available <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-1467__field--select-4_6a8926be47fee\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-4\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Select one of the following\" data-search=\"false\" data-search-placeholder=\"Select one of the following\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-1467__field--select-4_6a8926be47fee-label\"><option value=\"\"  >Select one of the following<\/option><option value=\"one\"  data-calculation=\"0\">Yes<\/option><option value=\"two\"  data-calculation=\"0\">No<\/option><\/select><\/div><\/div><div id=\"date-3\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-3-picker_6a8926be47fee\" id=\"forminator-field-date-3-picker_6a8926be47fee-label\" class=\"forminator-label\">SOP approval date<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-3\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-3-picker_6a8926be47fee\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-3\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-1467__field--select-3_6a8926be47fee\" id=\"forminator-form-1467__field--select-3_6a8926be47fee-label\" class=\"forminator-label\">Laboratory Setup Checklist Completed <span class=\"forminator-required\">*<\/span><\/label><select  id=\"forminator-form-1467__field--select-3_6a8926be47fee\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"1\" name=\"select-3\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"Select one of the following\" data-search=\"false\" data-search-placeholder=\"Select one of the following\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-1467__field--select-3_6a8926be47fee-label\"><option value=\"\"  >Select one of the following<\/option><option value=\"one\"  data-calculation=\"0\">yes<\/option><option value=\"two\"  data-calculation=\"0\">no<\/option><\/select><\/div><\/div><div id=\"date-2\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-2-picker_6a8926be47fee\" id=\"forminator-field-date-2-picker_6a8926be47fee-label\" class=\"forminator-label\">Date of Completion for Lab Setup Checklist<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-2\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-2-picker_6a8926be47fee\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\"><div id=\"select-5\" class=\"forminator-field-select forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-form-1467__field--select-5_6a8926be47fee\" id=\"forminator-form-1467__field--select-5_6a8926be47fee-label\" class=\"forminator-label\">Laboratory Closeout\/Decommision Checklist Completed<\/label><select  id=\"forminator-form-1467__field--select-5_6a8926be47fee\" class=\"forminator-select--field forminator-select2 forminator-select2-multiple\" data-required=\"\" name=\"select-5\" data-default-value=\"\" data-hidden-behavior=\"zero\" data-placeholder=\"\" data-search=\"false\" data-search-placeholder=\"\" data-checkbox=\"false\" data-allow-clear=\"false\" aria-labelledby=\"forminator-form-1467__field--select-5_6a8926be47fee-label\"><option value=\"one\"  data-calculation=\"0\">Yes<\/option><option value=\"two\"  data-calculation=\"0\">No<\/option><\/select><\/div><\/div><div id=\"date-4\" class=\"forminator-field-date forminator-col forminator-col-6 \"><div class=\"forminator-field\"><label for=\"forminator-field-date-4-picker_6a8926be47fee\" id=\"forminator-field-date-4-picker_6a8926be47fee-label\" class=\"forminator-label\">Date of completion for lab closeout\/decommission checklist<\/label><div class=\"forminator-input-with-icon\"><span class=\"forminator-icon-calendar\" aria-hidden=\"true\"><\/span><input autocomplete=\"off\" type=\"text\" size=\"1\" name=\"date-4\" value=\"\" placeholder=\"Choose Date\" id=\"forminator-field-date-4-picker_6a8926be47fee\" class=\"forminator-input forminator-datepicker\" data-required=\"\" data-format=\"mm\/dd\/yy\" data-restrict-type=\"\" data-restrict=\"\" data-start-year=\"1926\" data-end-year=\"2126\" data-past-dates=\"enable\" data-start-of-week=\"1\" data-start-date=\"\" data-end-date=\"\" data-start-field=\"\" data-end-field=\"\" data-start-offset=\"\" data-end-offset=\"\" data-disable-date=\"\" data-disable-range=\"\" \/><\/div><\/div><\/div><\/div><div class=\"forminator-row\" style=\"margin: 0;\"><div id=\"captcha-1\" class=\"forminator-field-captcha  forminator-col-12 \"><div class=\"forminator-captcha-left forminator-g-recaptcha recaptcha-invisible\" data-theme=\"light\" data-badge=\"bottomright\" data-sitekey=\"6LcCCBQdAAAAAP73y91aYkTmlJsRh0SvZzWKMuhk\" data-size=\"invisible\"><\/div> <\/div><\/div><input type=\"hidden\" name=\"referer_url\" value=\"\" \/><div class=\"forminator-row forminator-row-last\"><div class=\"forminator-col\"><div class=\"forminator-field\"><button class=\"forminator-button forminator-button-submit\">Submit Form<\/button><\/div><\/div><\/div><input type=\"hidden\" id=\"forminator_nonce\" name=\"forminator_nonce\" value=\"871b7d14c4\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/ehs\/wp-json\/wp\/v2\/pages\/2064\" \/><input type=\"hidden\" name=\"form_id\" value=\"1467\"><input type=\"hidden\" name=\"page_id\" value=\"2064\"><input type=\"hidden\" name=\"form_type\" value=\"default\"><input type=\"hidden\" name=\"current_url\" value=\"https:\/\/www.umes.edu\/ehs\/laboratory-registration-modification-request-form\/\"><input type=\"hidden\" name=\"render_id\" value=\"0\"><input type=\"hidden\" name=\"action\" value=\"forminator_submit_form_custom-forms\"><\/form><\/div>\n","protected":false},"excerpt":{"rendered":"<p>&#8230;<span class=\"cpschool-read-more-link-holder\"><a class=\"btn btn-basic cpschool-read-more-link\" href=\"https:\/\/www.umes.edu\/ehs\/laboratory-registration-modification-request-form\/\">Read more <span class=\"sr-only\">Laboratory Lifecycle assessment Request Form<\/span><\/a><\/span><\/p>\n","protected":false},"author":4122,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"_coblocks_attr":"","_coblocks_dimensions":"","_coblocks_responsive_height":"","_coblocks_accordion_ie_support":"","footnotes":""},"folder":[],"class_list":["post-2064","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/pages\/2064","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/users\/4122"}],"replies":[{"embeddable":true,"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/comments?post=2064"}],"version-history":[{"count":0,"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/pages\/2064\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/media?parent=2064"}],"wp:term":[{"taxonomy":"folder","embeddable":true,"href":"https:\/\/www.umes.edu\/ehs\/wp-json\/wp\/v2\/folder?post=2064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}