ࡱ> }|O  Tbjbj88 .tRWiRWi Mjj8Hd<D]$;;;;;;;$_><]<e<QQQF;Q;QQf9b;pgz7^2:;{<0<L:A|A4b;Ab;lZ@Q4O<<@<AjX : Bio-Hazardous and Radioactive Substances and Materials Use: Complete this form if hazardous materials, such as radioisotopes or infectious, mutagenic, carcinogenic or otherwise toxic agents are to be used on animals. Projects involving bio-hazardous materials require approval by the Bio-Safety Committee or the Radiation Safety Committee if radioactive materials are used. Signatures from the appropriate committee must be obtained on the last page of this document before this application is submitted to Research Services. Non-hazardous substances, agents, or materials. Complete the following table.Substance/Agent/ MaterialAmount to be GivenDelivery RouteNumber of Animals to be Administered Substance FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       FORMTEXT       Explain the role of each substance in your project. FORMTEXT       Anticipated Adverse Effects. Are any adverse effects on the animal expected? If yes, indicate what they are and how they will be handled to minimize stress and trauma to the animals.  FORMTEXT       Indicate the degree and nature of risk to personnel. FORMTEXT       Indicate the safety precautions that you will take. FORMTEXT       Indicate how you will store and dispose of hazardous materials. FORMTEXT       If the agent is infectious, indicate the risk to other animals in the ACF and how you will guard against infecting other animals. FORMTEXT   (6< " S T " $ T  ȻukaWMWWhIzOJQJ^Jh~OJQJ^JhxaOJQJ^JhyQOJQJ^Jhw0DOJQJ^JhyQ5OJQJ^Jh/OJQJ^JhIz5OJQJ^Jhxa5OJQJ^J h =h =CJOJQJ^JaJh =h =OJQJ^Jh =OJQJ^JhIz5CJOJQJ^JaJh!W5CJOJQJ^JaJh =5CJOJQJ^JaJ " $ gT & F$Ifl ukd$$Ifl!," t 6`lA0644 lap $lA&`#$/Ifl gd =gd =  < $$Ifa$l kkd$$Ifl,"," t0644 lalp   : <          * , . 0 2 4 6 8 : < 꽽꽽꽽꽽jKhw0DCJUaJjhw0DCJUaJj[hw0DCJUaJhw0D*jhw0DCJOJQJUaJmHnHujhw0DCJUaJhw0DCJaJjhw0DCJUaJh~OJQJ^J3  < I6666$Ifgdw0Dl kd$$Ifl\h,"# t0644 lalp(< > @ T V X Z \ ^ ` b d f h | ~ 꽽꽽꽽꽽}j!hw0DCJUaJjhw0DCJUaJjrhw0DCJUaJjhw0DCJUaJhw0D*jhw0DCJOJQJUaJmHnHujhw0DCJUaJhw0DCJaJjhw0DCJUaJhw0DOJQJ^J1< > f I6666$Ifgdw0Dl kd$$Ifl\h,"# t0644 lalp(  0 X I6666$Ifgdw0Dl kdb$$Ifl\h,"# t0644 lalp(      " $ & ( * , . 0 2 F H J L N P R T V X Z n p r t v x z | ~ ѳѤٚыj hw0DCJUaJhw0DOJQJ^Jjhw0DCJUaJjhw0DCJUaJjhw0DCJUaJhw0DCJaJhw0D*jhw0DCJOJQJUaJmHnHujhw0DCJUaJ6 "I6666$Ifgdw0Dl kd $$Ifl\h,"# t0644 lalp(  "$&:<>@BDFHJLNbdfÛ}j hw0DCJUaJj_ hw0DCJUaJhw0DOJQJ^Jj( hw0DCJUaJj hw0DCJUaJhw0D*jhw0DCJOJQJUaJmHnHujhw0DCJUaJj8 hw0DCJUaJhw0DCJaJ1"$LtI6666$Ifgdw0Dl kd $$Ifl\h,"# t0644 lalp(fhjlnprtv024HҴڪznhxaCJOJQJaJjhxaCJOJQJUaJhxaOJQJ^Jhxa5OJQJ^Jh*T5OJQJ^Jhw0DOJQJ^Jj hw0DCJUaJjO hw0DCJUaJhw0DCJaJhw0Djhw0DCJUaJ*jhw0DCJOJQJUaJmHnHu#0I6# & F$Ifl $Ifgd*Tl kd?$$Ifl\h,"# t0644 lalp(02Z$Ifgdxal kkd$$Ifl,"," t0644 lalp HJLNPRTVXZ\^vxjlnܺܺqܺܺ%j#hxaCJOJQJUaJhxa5OJQJ^Jh ][5OJQJ^Jh{5OJQJ^Jh*T5OJQJ^JhxaOJQJ^JhxaCJOJQJaJ*jhxaCJOJQJUaJmHnHujhxaCJOJQJUaJ%jhxaCJOJQJUaJ%Z\^m & F$Ifl $Ifgd*Tl kkd$$Ifl,"," t0644 lalp $Ifgdxal kkd$$Ifl,"," t0644 lalp jm & F$Ifl $Ifgd*Tl kkd$$Ifl,"," t0644 lalp jl$Ifgdxal kkd*$$Ifl,"," t0644 lalp  "$&(*,.ܺܺܺܺtܺܺ%jhxaCJOJQJUaJ%jOhxaCJOJQJUaJhxa5OJQJ^Jh*T5OJQJ^JhxaOJQJ^JhxaCJOJQJaJ*jhxaCJOJQJUaJmHnHujhxaCJOJQJUaJ%jhxaCJOJQJUaJ-m & F$Ifl $Ifgd*Tl kkd1$$Ifl,"," t0644 lalp *$Ifgdxal kkd$$Ifl,"," t0644 lalp *,.m & F$Ifl $Ifgd*Tl kkd$$Ifl,"," t0644 lalp $Ifgdxal kkdV$$Ifl,"," t0644 lalp m & F$Ifl $Ifgd*Tl kkd]$$Ifl,"," t0644 lalp  L$Ifgdxal kkd$$Ifl,"," t0644 lalp LLLLL L LLL L6LMM MMNXNNNNNNNܸxmxxcXJjh*OJQJU^Jh/5OJQJ^Jh ][OJQJ^JhIz6OJQJ^Jh/6OJQJ^Jh/OJQJ^JhIz5OJQJ^Jh{5OJQJ^Jh*T5OJQJ^JhxaOJQJ^JhxaCJOJQJaJU*jhxaCJOJQJUaJmHnHujhxaCJOJQJUaJ%j{hxaCJOJQJUaJ    Risk to personnel. Will the animals used present a significant risk to personnel in terms of naturally-carried infectious agents? (e.g., viral, bacterial, fungal or parasitic agents - please consult the NRC publication on Occupational Health and Safety in the Care and Use of Research Animals, in particular Table 3-2 and Chapter 5.) FORMCHECKBOX  No  FORMCHECKBOX  Yes.If no, please explain your reasons for concluding that there are no significant infectious risks. FORMTEXT      If yes, please indicate the infectious agent the degree and nature of the risk and the safety precautions you will take to prevent infection. FORMTEXT       Authorizing Signatures. The signatures of approval from the appropriate committees are required before submission of the application to Research Services. 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