BCF New User Scope of Work Form

Please fill in a valid value for all required fields

Please ensure all values are in a proper format.

Are you sure you want to leave this form and resume later?

Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.

You must upload one of the following file types for the selected field:

There was an error displaying the form. Please copy and paste the embed code again.

There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.

Today's date*

Are you*

University at Buffalo student University at Buffalo post-doc or visiting scholar University at Buffalo faculty or staff Faculty, student or staff from another institute of higher education Industry

Company name*

Which lab/s are you interested in using?*

BioDesign Core Facility

First name*

Last name*

UB Email*

Gmail*

Phone*

Person number*

Last 8 digits of the 16 digit number on your UBID card (see sample below)*

sample UB card with the last 8 digits of the 16 digit card number highlighted in red

Advisor's first name*

Advisor's last name*

Advisor's email (an email will be sent to your advisor requesting authorization for your use of the lab/s.)*

Department*

Please specify department*

Degree pursued*

Anticipated graduation date*

How did you hear about UB's Shared Labs?*

Research description: please provide a brief project summary*

What equipment do you plan on using (check all that apply)?*

Mass Spectrometer (MS) – Thermo Scientific, Orbitrap XL Centrifugal Evaporating System - Labconco CentriVap® Concentrator System Zetasizer – Malvern Panalytical Advance Series Ultra Zetasizer - Malvern Panalytical Advance Ultra (Red Label)

What chemicals or materials will you be working with?

For guidance, please see a listing of acids and solvents provided by the Shared Instrumentation Laboratories here.

What date did you complete Initial Orientation and Training for the Bonner Hall BioDesign Core Facility?*

Upload a completed and signed Initial Orientation and Training Certification form for the Bonner Hall BioDesign Core Facility*

No File Chosen

File uploads may not work on some mobile devices.

What date did you complete EH&S Laboratory Safety Training?*

Sample EH&S laboratory safety training certification:

sample EH&S certificate with the name, date and instructor information redacted

Upload your Laboratory Safety Training certification card from EH&S (all training must have been completed within the last 12 months)*

No File Chosen

File uploads may not work on some mobile devices.

STAFF ONLY: Upload Laboratory Safety Training certification card from EH&S original training was completed prior to the change to online system

No File Chosen

File uploads may not work on some mobile devices.

This document outlines the governing principles, facility guidelines and regulations of the lab. Please take the time to read them carefully to understand the expectations associated with the use of the laboratory.

Bonner Hall BioDesign Core Facility Governance Document

The BioDesign Core Facility (BCF) is operated as part of the University’s Shared Instrumentation Laboratories (SIL). It is available for use by authorized UB researchers, students, and outside academic or industrial users. Authorized users are required to complete Lab Safety Training from UB’s Office of Environmental Health & Safety (EH&S; http://www.buffalo.edu/facilities/ehs/lab-safety/lab-safety-training.html) within the last year, and complete lab-specific safety and equipment orientation with SIL personnel.
These BioDesign Core Facility-specific orientations usually takes place on Tuesdays at 2 pm at the main entrance to the laboratory, located in 116 Bonner Hall.
BioDesign Core fees are collected monthly and are used to support laboratory supplies and equipment maintenance costs. A one-time, per-person orientation and training fee is also collected for new users.
Entry is by swipe card only. Each user must swipe into the laboratory with their own UB ID card, and they are not allowed to bring guests into the laboratory. No visitors or observers are allowed.
No food or drink is allowed in the laboratory.
A swipe log computer is located in the collaboration room. All users must log in and log out for each individual piece of equipment used, i.e., log in when you begin your use of laboratory equipment, and log out, upon completion of equipment use. A password to access the system, is displayed on the front of the computer monitor.
No users may wear shorts or open-toed shoes into the laboratory. Skirts and dresses are not recommended/permitted. High-heeled shoes are not allowed. Flat bottom shoes are recommended.
All users of the facility are required to wear proper personal protective equipment (PPE), i.e., lab coats, safety glasses or goggles and gloves are required to be worn at all times when working in the laboratory. All required PPE is available on the racks inside the laboratory. You may hang up your coat for short-term re-use. DO NOT WRITE YOUR NAME on the coats. If you will not return for more than one week, you are required dispose of any disposable coats in the proper receptacle within the lab. Please place your re-usable lab coat in the dirty laundry basket so it can be cleaned and returned for use in the lab.
BCF management needs to be apprised of all proposed activities for the facility.
No chemicals or equipment are to be brought into or removed from the BioDesign Core Facility without staff’s permission and knowledge.
When using any chemicals, it is to be done in a fume hood. Anyone using acids is required to wear a face shield in addition to the normal goggles and acid gloves (provided by the laboratory). Acid aprons are also provided.
Safety and procedural rules will be enforced. Violations can result in disciplinary actions.
You or your source of funding may be held liable for all or any damages caused by negligent behavior while in any of the lab areas.
For safety reasons, it is recommended that users work in pairs (particularly outside of normal business hours of 8am-5pm M-F. Note you are required to have a lab partner when working with acids.
Pregnant users should seek advice before working with substances that are suspected to be reproductive toxins. The long term effects of all chemicals and electromagnetic fields are not known and the permissible exposure limits are based on present knowledge and thus not updated until new knowledge of potential hazards has been discovered, pregnant women should always take more care!
Glass slides and broken glass must be placed in the red plastic sharps containers located throughout the lab space.
Workspaces must be kept neat and clean during and after each use. Return chairs and stools to their proper spaces under or at tables.
All waste must be collected in bottles and stored in the designated waste trays; only compatible chemical waste may be collected in the same bottle.
No chemicals may be washed down the sink drains (only final rinse water is acceptable).
Empty chemical bottles are to be rinsed clean with water and marked RCRA empty for waste usage. Do not discard rinse down the drain; pour rinse into chemical waste bottle and label for proper disposal. No chemical bottles are to be placed in the trash.
Empty waste bottles are located near the waste trays.
Users can be billed for any calendar-scheduled use of equipment.

Rev: 12/11/2018 AF

Accept the terms of the governance document*

By checking this box, I certify that the information provided herein is accurate to the best of my knowledge and certify that I have read and understand the Governance Document and agree to abide by the rules of the Bonner Hall BioDesign Core Facility.

Billing contact information

Please provide the following information for the person within your organization that should receive lab invoices.

Name*

First Name

Last Name

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone*

Status

Deactivated

COVID-19 governance supplement completed?

Yes No

Date COVID-19 governance supplement completed