Department of Chemistry

National University of Singapore

Laboratory handover/takeover form

I, am taking over / handing over Lab

(name of PI) (Location)

on . I have checked that the following location is 1) cleared of all

(Date)

glasswares, chemicals and laboratory apparatus and 2) clean 3) fixtures in good condition

Item* Good All Item* Good All

Condition# Cleared# Condition# Cleared#
Safety Shower Fumehoods
Eye Wash Lab bench
Lightings Cupboards
Fans Air conditioner
Office Others:
*if applicable # Tick when applicable

Signature of PI Date

Certified by:

Comments (if any):

1 Accepted / Not Accepted:

Signature of PSSO Representative / Date

2 Accepted / Not Accepted:

Signature of Safety Committee Representative / Date

3 Accepted / Not Accepted:

Signature of Space Committee Representative / Date