Forms

Construction Safety

• Construction Safety Management Program
• Contractor Handbook
• Construction Safety Process Flowchart
• Project Managers Contractor Safety eLearning Module
• EOC PCRA (Pre-Construction Risk Assessment)

Emergency Management Forms

• Available on Emergency Preparedness and Response page

Area Specific Evacuation Plan

Login/Password identical to your initial computer login and websense credentials

• Create/Edit Area-Specific Evacuation Plans
• LiquidOffice Inbox (for continuing incomplete, saved survey forms)
• ASEP Job Action Sheet Examples
• Specific Evacuation Plan/ASEP Department Plan Lookup

Back to top

Environment of Care Forms

• EOC Infograph
• EOC Self-Tour Form
• Safety Inspection Checklist (University or LLUSS Departments)

Back to top

Environmental Management Forms

• Asbestos and Lead Abatement Contractors
• Hazardous Waste Pick-up Request Form
• Safe Use Guides: CIDEX OPA Solution  |  CIDEX Plus 28 Day Solution

Back to top

Fire & Life Safety Forms

• Fire Drill Form
• Fire/Code Red Drill Scenario Cards
• Flow Chart for Determining Frequency (Quarterly vs. Annual)
• Life Safety & Fire Prevention Plan
• LLU - Fire Evacuation Drill Planning Checklist
• RA Dorm Fire Safety Inspection

Fire Extinguisher/Exit Light Inspection Forms:

• Monthly Extinguisher & Emergency/Exit Light Inspection Forms (Liquid Office)
• Indio O/P Pavilion - Extinguisher/Exit Light Inspection Form

Permit Forms:

• Outdoor Event Space Request (click SUBMIT REQUEST button to access form)
• Fire Watch Documentation Form
• Hot Work Daily Inspection
• Hot Work Permit Application
• Red Tag Permit Application

Special Event Permitting Forms:

• Special Events Permitting Workflow
• NFPA Food Truck Fact Sheet
• City of Loma Linda:
  • Special Event Permit Application
  • Tent/Canopy Application
  • Tent and Canopy Requirements
  • Food Truck Requirements
• City of San Bernardino
  • Special Event Permit Application
  • Tent/Canopy Application
  • Tent and Canopy Requirements
• City of Redlands
  • Special Event Permit Application
• City of Beaumont
  • Special Event Permit Application
  • Tent/Canopy Application
  • Special Event Requirements
• City of Riverside
  • Special Event Permit Application
  • Tent/Canopy Application

ILSM Forms:

• Report/Request ILSM Form

Back to top

Laboratory Safety Forms

• Accessing Safety Data Sheets in incora|HAZCOM (formerly MAXCOM)
• Eyewash & Shower Inspection Logsheet
• Hazardous Waste Pick-up Request Form
• Laboratory Safety Checklist
• Management of Certain Potentially Explosive Chemicals Log Sheet

Laboratory Safety Documents

• ChemTel Certificate of Compliance
• ChemTel Emergency Response & Safety Data Sheet Hotline
• Globally Harmonized System Training Document 
• incora|HAZCOM (formerly MAXCOM) SuperUser Function
• Laboratory Site Safety Orientation Checklist
• Liquid Nitrogen, Dry Ice, and other Cryogenics - Safe Use
• Mandatory Trainings and Documents for Laboratories
• P-Listed Chemicals
• PHS - List of Particularly Hazardous Substances with Hazards
• Site Safety Chemical Hygiene Plan Instructions

Lentiviral Vector Safety

Lentiviral Vector Safety Training Documents

• Biosafety Considerations for Research with Lentiviral Vectors
• Consideration of Biosafety Level Assignment for Lentiviral Vectors at Vanderbilt University
• NIH Guidelines for Research Involving Recombinant DNA Molecules
• Information About Potential Risk in Using Lentiviral Vectors (Disclosure)
• Lentiviral Vector Laboratory Safety Checklist 

Lentiviral Vector Safety Reference Documents

• Briefing Document
• State-of-the-Art Lentiviral Vectors for Research Use
• Example SOPs for Lentiviral Waste Decontamination and Disposal

Lentiviral Vector Post-Exposure Guidance

• Print and Go Lentiviral Vector Post-Exposure Information Sheet

Back to top

Occupational Safety Forms

Eye/Face Wash

• Eye/Face Wash Instructions
• Guardian Eye Wash Instructions
• Speakman Eye Wash Instructions
• Monthly Eye Wash Log Sheet - BMC | CH | ECH | LLU | MC | MUR | SH | UHC | USS

Fall Protection Forms:

• Fall Protection Harness Lanyard Checkout
• Fall Protection Pre-Work Checklist
• Harness & Lanyard Inspection Form

Forklift Safety Forms:

• Operator's Pre-Trip Checklist - Electric Forklift
• Operator's Pre-Trip Checklist - Gas/LPG/Diesel Truck

Heat Illness:

• Appendix A - Department Procedures Directions
• Appendix B - Heat Illness Sign-in Sheet

Illness & Injury Forms:

• Identified Hazards and Corrective Action Record
• Report an Injury
• Job Safety Analysis Employee Input Form
• Job Safety Analysis Form
• Neutral Work Postures
• Office Self-Inspection Checklist 
• Shop Self-Inspection Checklist
• Verbal Warning Form
• Written Warning Form

N-95 Fit Testing Forms

OSHA 300A Summary Logs:

• BMC
• CH
• LLIECHE
• LLU
• MC (UH, EC, SH, Ancillary, Infrastructure)
• Murrieta
• UHC
• USS

PPE (Personal Protective Equipment):

• PPE Hazard Assessment Form & Instructions

Back to top

Safe Patient Handling and Mobility

• Elearning and Hands-On Training OWL Registration Process
• Musculoskeletal Injury Prevention Plan
• Safe Patient Handling and Mobility Elearning
• Safe Patient Handling Policy -   UH  |  CH  |  Murrieta
• Safe Patient Handling and Mobility Recommendation – ELearning and Hands-on Training with the Equipment

Back to top

Safety Coordinator Forms

• New Hire Safety Checklist
• Safety Coordinator of the Year Nomination Form
• Safety Coordinator Registration/Update Form
• Safety Response Manual

Back to top

Workplace Violence

• Management of WPV Behavior
• Workplace Violence Prevention Situational Awareness Tips
• Workplace Violence Reporting FAQs
• Workplace Violence Response Guide
• WPV Resources

Miscellaneous Forms

• BLUE Book OWL Portal Access Instructions from:  Work Station  |  Home  |  MyLLU
• FET Regular Session Instructions & FAQs
• Hazard/Complaint Form
• Instructions for Training Certificates from CE Portal 
• LLUH Who to Call
• LLUHBB Who to Call
• Murrieta Call Tree
• Murrieta Online Pesticide Form Instructions
• Online Pesticide Form Instructions
• Drone/Unmanned Aircraft Systems (UAS) Operations Request

Back to top