Liquid Nitrogen Safe Handling Procedure [SAFE 1.0] Certificate

Liquid Nitrogen Handling Procedure [SAFE 1.0] Certification

The individual listed below has read and fully understands procedure SAFE 1.0 Liquid Nitrogen Handling Procedure. They have received training from their laboratory manager or PI, and agree to follow all department protocols listed in the above procedure.

Type of submission*
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Name*
First Last
Date*
MM slash DD slash YYYY
UWM Email*

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Are you associated with a research lab as a student or employee?*
Who is the PI for the lab you are associated with?*
Trainer Name:*
Individuals must receive initial training from their PI, supervisor, or a lab manager.
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- I have received training by the person selected above, and have had the opportuninty to ask questions.
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*
- I have reviewed and fully understand the procedure listed above.
Initials or signature*
Use a computer mouse or touchscreen device to sign in the area below.
Initials or signature of trainee*
Use a computer mouse or touchscreen device to sign in the areas below.
To be filled out by the supervisor/instructor/trainer:*
- I certify that the individual listed above has been trained, and has demonstrated the ability to follow this procedure.
Initials or signature of trainer*
Initials or signature of trainer