Forms

Fillable forms should be downloaded and opened in Foxit Reader, Adobe Reader, Adobe Acrobat, or Google Chrome.

Hazardous Material (HAZMAT) forms

Tier II reporting documentation

• EHI-12-03 Form (Emergency HAZMAT Inventory Form (PDF)
• Instructions for the EHI-12-03 Form (PDF)
• Completed example of the EHI-12-03 Form (PDF)
• Specific Gravity Worksheet (PDF)
• Tier II Appendix A (List of Extremely Hazardous Chemicals-PDF)
• Appendix B - 49CFR Part 172.101 (List of Hazardous Materials-Text File)

HAZMAT waste disposal documentation

• Hazardous Waste Disposal Request Form (HWD-11-00)

Motor vehicle and water vessel forms

• Motor Vehicle Accident Reporting Form (DA 2041)
• Water Vessel Authorization and Driving History Form (DA2066)
• Water Vessel Operator Accident Reporting Form (DWF-DIR-005)
• Monthly Fleet Vehicle Preventative Maintenance Checklist Form - (Rear of the MV3 form)
• Monthly Fleet Water Vessel Preventative Maintenance Checklist Form
• Hold Harmless Document (For persons other than University employees riding in state vehicles)

DSC quarterly safety meeting and building inspection forms

• High-Risk Safety Meeting Form (SMR-9-00)
• Low-Risk Safety Meeting Form
• Building Safety Inspection Form (BSI-10-08)
• DSC Employee Representation Forms (ERF-8-01)

Accident reporting forms:

• Procedures for On-the-Job Injuries (Worker Compensation)
• Employee Incident/Accident Reporting Form (DA 2000)  & Guidance for Completing Root Cause Analysis
• NON-Employee Incident/Accident Reporting Form (DA 3000)

Other forms (employee information)

• Quick Reference Guide (For UL Lafayette employees)
• Job Safety Analysis Form
• University Key Policy & Key Request Form
• Fire Drill Response Form
• Ergonomic Workstation Analysis Form
• Security Alarm Information Sheet (Excel)
• Security Alarm Information Sheet Instructions
• Employee Drug Testing Reasonable Suspicion Checklist Form
• Drug Testing Consent Form
• Fire Extinguisher Inspection Form
• Reporting Property Claims Form