I, ______, agree to abide by the following safety precautions

Print your full name on this line.

whenever I work in the chemistry lab. I understand that minor infractions by a student may result in a reduced lab grade. A major infraction will result in removal from the lab, notification of a parent or guardian, and a failing grade on the lab work. A further major infraction may result in elimination of laboratory privileges, as well as a failing lab grade, for an interval determined by LEHS administration. This contract will be kept on file in the chemistry office for the duration of the school year.*

  1. Always wear safety goggles (and lab apron if instructed by teacher).
  2. Do not wear contact lenses in the lab.
  3. Never work alone in the laboratory.
  4. Only materials needed for the experiment should be in the lab.
  5. Read the entire experiment before entering the lab – never modify the written procedure unless

instructed to do so by the teacher.

  1. Wear the right clothing for the lab.
  2. No dangling jewelry
  3. No loose clothing, or dangling long sleeves
  4. No open-toed shoes
  5. Tie back long hair.
  6. No horseplay or fooling around in the lab.
  7. Do not use broken or cracked glass, ceramic, or metal ware – return suspect equipment to the

teacher for inspection and replacement.

  1. No food, beverages, chewing gum, or cosmetic products in the lab area during a lab.
  2. Use and dispose of chemicals according to directions.
  3. Read chemical labels carefully to be certain you are using the correct substance.
  4. For all chemicals, take only what you need.
  5. Never taste chemicals or touch them with your bare hands.
  6. Never take chemicals out of the lab.
  7. Do not use bare hands to handle glass, ceramic, or metal ware that has been recently heated until certain that the devices have cooled sufficiently – remember, a hot beaker looks just like a cold

beaker.

  1. If electrical equipment is used in the lab:
  2. make sure that wires are not frayed or twisted.
  3. be sure your hands are dry.
  4. do not let electrical cords dangle from work stations.
  5. Keep your work station clean and neat.
  6. Clean glassware according to the teacher’s directions.
  7. If you spill anything on the floor or lab table, call the teacher before trying to clean it up yourself.
  8. Never reach into the sink to retrieve broken glassware – notify the teacher immediately if broken glass gets into a sink.
  9. Do not use the lab station sinks as trash receptacles – throw all paper toweling, filter papers, and litmus or pH papers in a trash can.
  10. Broken glassware should only be put into the trash receptacle labeled for “sharps”.
  11. Chemicals should not be disposed of down the sink – follow directions given by the

teacher for disposal of unused or waste chemicals.

  1. Always wash your hands with soap and water before you leave the lab.
  2. All adverse incidents, no matter how minor, should be reported to the teacher.
  3. Chemicals spilled on your skin – wash off immediately, then call the teacher.
  4. A chemical gets in your eye – use the eyewash immediately and have your lab partner report the incident to the teacher.
  5. Cut by broken glassware – rinse the injured area at the sink and have your lab partner notify the teacher.
  6. Any burns should be reported to the teacher immediately.
  7. Headache, dizziness, or upset stomach during a lab should be immediately reported to the

teacher.

Before signing this contract, be certain that you have been shown the location of, and have been instructed

in the proper use of the following safety equipment:

Safety shower

Eyewash fountain

Fire Blanket

Fire Extinguisher

Spill Kit

Any medical condition(s) that may impact a student’s wellbeing in the laboratory, such as asthma, allergies, or epilepsy, should be reported to the teacher. This information will be kept confidential.

______

Student Signature Date

______

Parent or Guardian Signature Date

* Upon request, students can receive a copy of this signed agreement for their own personal records.