WPC  :*>KK"{y6id]iga3eKO>*oF_Ը`QӀ~Ay/L@x")amժ=j'}78k'~oCO_eu 8͆U=MMD4#'<̢pQ",ΪAt. u_V."# ~H ?@kG {B}˒uAэY]B(0a`H=/JPZH_Q1 rN57P{B>G 2291jrX < N$&=9ȓLuEF0Z>_΋|-y/Kqt4UKY56\ (xg 7̤"w4b ^Fl˽hS,PYVHmxD ~/snƷZL(U.8 %f 0lUF|Ut2faf w@ 4L a` t | #!~ N m B 0 D+ 3|x<6X9`+CourierX(0?$TRY3'"Letter (Portrait)Y3'"Letter (Portrait) 3' Letter 3' LetterThhhhhh hhXXXXXXXX<09Z .Courier New Regular02Ap`HelveticaPTABLE A EE#EEED6(8C88ooTABLE B\\SAFETY\338-HP8100DN0U d""Π:literal HTMLConverted directly to HTML with no mappingX+ XXX X+ XXX 'dxd 0?!TRX3'"Letter (Portrait)3'3' Letter3'Thhhh hhXXXXXXXX  _  XXUNIVERSITYOFMARYLAND#XX"# h XXRegistrationofAnimalPathogens#XX#Ԁ  R TheDepartmentofEnvironmentalSafety(DES)maintainsaregistryoflaboratoriesworkingwithanimalpathogens.ThePrincipalInvestigator(PI)isresponsibleforcompletingthepertinentpartsofthisregistrationdocumentandsendingittotheBiologicalSafetyOfficeratDESpriortothebeginningofthework.ThePIisalsoresponsiblefornotifyingDESwhenworkwiththemicroorganismisterminatedorwhensignificantchangesoccur,suchasrelocationofthelaboratoryorintroductionofanewpathogen.## 6  *w!ddd Xdd Xdd Xhp&hp&w,1 dd , dd ,dd +    r   PARTA (Tobecompletedforeachlaboratory.)#s#  >  PI:  6    F  Department   6  Building:  *  LaboratoryRoom(s)involved    Telephone    MailingAddress,ifdifferent  f Building  : Room  : Telephone##  J  PARTB Ԁ(Tobecompletedbylaboratorieshandlinganimalpathogens.Providecompleteinformationforeachmicroorganisminuseinyour @ laboratory.)#ŧ#  t  %Organism(s)___________________#Ŭ #Ԁ%SpecificStrains__________________# # H   z Isantibioticresistanceexpressed?#ŭ # p %No#, #Ԁ%Yes#v #    Doesorganismhave_zoonotic_Ԁpotential? p! # #%No#x #Ԁ%Yes# # "   J# LargestVolumeoforganismcultured @$ ____________liter(s).#4 #  P% Isatoxinproduced?# #Ԁ%No#9#Ԁ%YesWorkwithtoxin?#Ń#Ԁ%No##Ԁ%Yes#.#  @& Doyouconcentratetheorganism?#ŋ# $' %No##Ԁ%Yes#S#  4( SpecifyMethods#ű# $) %Centrifugation##Ԁ%Precipitation#s# 4* %Filtration##Ԁ%Other____________#6#  + Isorganisminactivatedpriortodisposal? \, #Ţ#%No#*#Ԁ%Yes#v#   f. SpecifyMethods## \/ %Autoclaving#?#Ԁ%Incineration#ř#Ԁ%Chemical##Ԁ%Other____________#U#   0 Isorganisminjectedintoanimals?## ," 1 %No#?#Ԁ%Yes#ŋ# "l!2   #6"3 Specifyanimals ," 4 Animalstudieswillbedoneunder_ACUC_Ԁprotocol#_____________,date_____________##  |#"6 Doyouworkwithradioactivelylabeled $#7 organisms?## %<$8 %No#Œ#Ԁ%Yes##Ԁ_Radionuclide_Ԁ_______#$# '%: CallRadiationSafetyforassistance5_Ԅ39885.#ů#_  'x&; Containmentequipmentavailable $#< BiologicalSafetyCabinet#k#%ClassI##Ԁ%ClassII#O# %<$= %ChemicalFumeHood#ų#Ԁ%ContainmentCentrifuge##Ԁ%Other__________#o# n&%> IsBiologicalSafetyCabinetcertifiedannually?#:#%No#Ų#Ԁ%Yes##  (&@ Iacceptresponsibilityforthesafeconductofworkwiththisorganismat_Biosafety_ԀLevel_____(indicateappropriatelevel)andhaveinformedall `)'A personnelwhomaybeatriskofpotentialexposuretotheorganismoftheconditionsofthiswork.___________________________________________________________________̀PrincipalInvestigator(signature)Date#]#/.K  ,,Rev.1/9988#,, # *1/L   *1/L Л*w ! dd1 dd  dd dd !hp&hp&w,dd ,dd +   h  PARTC: (Tobecompletedbylaboratorieshandlinghumanblood,tissuesorfluids)  d Humansamplesmanipulated:BloodSerum P UrineFeces  SpinalFluidSemen H UnfixedTissuesOther____________  ( TypeofmanipulationsCentrifugeSonication   Blending/mixingPipetting H  DissectionOther____________  ( ContainmentequipmentavailablèBiologicalSafetyClassIClassIIClassIIIChemicalFumeHoodContainmentCentrifuge 4  ЀCabinetOther_________________________________________________________   IsBiologicalSafetyCabinetcertifiedannually?NoYes  $  Iacceptresponsibilityforthesafeconductofworkwiththeabovementionedhumanblood,bodyfluidsand/ortissuesusingBiosafetyLevel2practicesandprocedures.Ihaveinformedallpersonnelwhomaybeatriskofpotentialexposuretothesematerialsoftheappropriateproceduresforthiswork.̀_______________________________________________________________________________________________̀PrincipalInvestigator(signature)Date    PARTD: (TobecompletedbytheInstitutionalBiosafetyCommittee(IBC)andDES.)  x МReviewersComments:____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________PartsAandBofthisregistrationdocumentwerereviewedbytheIBCon________________________________andworkcanproceedinaBL________facilityusingBL___________practicesandprocedures.______________________̀Chair,IBCDateofCertificationBLBiologicalSafetyOfficer____________________________________________________________________________________________________________________________________________________________________________________________________________________________________  l (TobecompletedbyDESuponnotificationthatthisworkisterminated.)  0 DateRegistrationDocumentInactivated_____________________________________________________________By:_________________________̀BiologicalSafetyOfficer     0/K   Returncompletedformto:theBiologicalSafetyOfficer,DES