Swinburne Biosafety Committee

Annual/Final report for use of biohazardous materials

DATE RECEIVED
Office use only

Please note that this report must be submitted for all projects approved by the SBC, whether continuing or not. If you wish to continue the project, this report will be the basis on which continuation is approved.

Please also note that major modifications may require submission of a new application.

SBC REFERENCE NUMBER
DATE OFAPPROVAL OF PROJECT / DATE OF THIS REPORT
ANNUAL/FINAL REPORT (Delete as applicable)
1 / Title of project
2 / Chief Investigator
3 / Personnel: Are there any changes to personnel
a)New personnel? / Yes/No (If Yes, fill in details below)
Title: / Name: / Title:
Department: / Campus:
Full postal address (including internal mail details):
Phone: / Fax:
Email (MUST be staff email address):
b)Have any personnel left? / Yes/No (If Yes, fill in details below)
4 / Project Summary - briefly restate the purpose of the project(This should be written in plain English)
5 / Have any approved protocols/procedures changed? (If yes, please provide SOPs and Risk Assessments relevant to biohazardous aspect of the project)
6 / Changes to Facilities Yes/No (If yes, fill in details below)
Building number: / Room Number:
7 / Have there been any reportable incidents in the last 12 months? (If yes, please briefly describe the incident and the actions taken)
8 / Sign-off
Chief Investigator
I declare that the above project has been developed and will be conducted in accordance with relevant Swinburne standards, policies and codes of practice, including any standard or special conditions for on-going biosafety clearance. I further declare that all listed and subsequently appointed researchers or assistants involved in this project will be made aware of the conditions of approval as communicated to me, including approved documentation and procedures.
Name:
Signature: