We review all materials for compatibility with an open use environment taking care to avoid situations that place individuals at safety risk or their experiments at risk for cross-contamination.

Please be prepared to work with us to ensure we get useful information about your requested materials quickly.  We will likely ask you for follow-up information.  Please let us know if a deadline is involved but please be aware that it may take up to one-to-two weeks to complete the evaluation process.

Use this form to request any user-supplied material for use in any tool or process in the Nanofab.

• Any liquid, target, pellet, membrane, substrate, etc. not provided by Staff
• Any sample, device, or substrate that has been partially or fully processed outside the Nanofab
• Any material provided by the Nanofab that will be used in a manner not defined by an existing SOP
• Any material that has been previously approved, but has expired or approved for another user

Do not order the material until after approval has been granted.  (There is no guarantee approval will be given.)

At this time, partial completions of the form cannot be saved. Exiting the form before entering all required fields will lose all information.

If existing SOP’s do not provide adequate processing and handling instructions, you MUST prepare an appropriate SOP prior to submitting the request.  Please download and use the New Chemical SOP template to create the necessary SOP.  Attach the new SOP to this request.  Where multiple chemicals are being requested for a processing step, a single SOP for the processing step that includes all chemicals should be submitted.

New Materials Request Form

Request ID (field not editable - auto-populated) *

Submission Date *

Requester Name *

Requester Email *

Requester Phone *

PI Name *

PI Email

PI Phone

Name of new chemical or material *

MUST match the name given on the SDS and/or product label.

Alternate Names / Synonymns

Only include those specifically listed on the SDS.

Requested Users *

Please provide the names of all lab members that need to be authorized to use this material. If authorization is needed for the entire research group of a PI, please provide the group name.

Expected Start Date *

When do you plan/need to start using this material in the Cleanroom?

Expected Completion Date *

What date do you expect to be completed with the project that requires this material? (If the shelf life of the material expires before the project completion date, you will be responsible to discard the expired material per specified procedures.)

Vendor *

Vendor Phone

Vendor Website

Product Number *

Vendors part, product, or material number

Form of Material * LiquidPowderSolidGasOther Form of Material

Amount of Material *

Provide the maximum quantity of material needed in the lab at any given time.

Include the current version of the SDS as an attachment *

Drop a file here or click to upload Choose File

Maximum file size: 419.43MB

Attach a CURRENT version of the SDS from the vendor. Older versions obtained through an internet search will not be accepted.

SDS *

I have read the SDS

Exposure Control Reference *

PEL (Permissible Exposure Limit)

TLV (Threshold Limit Value)

OEL (Occupational Exposure Limit)

LD50 (50% of Lethal Dose observed in animal testing)

OtherOther

No Exposure Control Reference Listed on this SDS

If the SDS lists a PEL, select the PEL box. If it lists a TLV or an OEL, select its respective box. If it doesn't list a PEL, TLV, or OEL, but lists LD50, select the LD50 box. If some other exposure control reference is listed, select other.

Exposure Control Value *

Numerical value SDS lists for the Exposure Control method selected above. If no exposure control method was found in the SDS, enter 0 here.

Units of Exposure Control Value * mg/m3micrograms/m3ppmppbmg/kgmicrograms/kgOther Units of Exposure Control Value

Select the box for the units of the exposure control method above. If no exposure control method is included in the SDS, enter NONE in the field next to Other.

SDS Section 2: GHS Classification (Check all that apply) *

Acute Toxicity

Skin Corrosion/Irritation

Serious Eye Damage/Irritation

Respiratory/Skin Sensitization

Germ Cell Mutagenicity

Carcinogenicity

Reproductive Toxicity

Specific Target Organ Toxicity (Single Exposure)

Specific Target Organ Toxicity (Repeated Exposure)

Aspiration Hazard

SDS shows none of these classifications for this material

Other Hazards (Check all that apply) *

Biohazard

Compressed Gas

Explosive

Flammable

Harmful to Aquatic Life

Liquefied Gas

Oxidizer

Pyrophoric

Water Reactive

SDS shows none of these

Reason for Request *

Include a description why our current processes, chemicals, and/or methods cannot meet your needs. Include any relevant information from the supplier or other sources.

Proposed Use *

Give a brief description of the Standard Operating Procedure (SOP).

Do existing Nanofab SOP's provide all necessary instructions for use of the material? *

Yes

No

If existing, published Standard Operating Procedures (SOP's) for the Nanofab can be used with no exceptions, select "Yes". Otherwise, select "No", create an applicable SOP, and attach it to this request as directed below.

What SOP(s)? *

List all applicable SOP's.

Upload Standard Operating Procedure (SOP) *

Drop a file here or click to upload Choose File

Maximum file size: 419.43MB

Proposed Use, Storage, Waste should be included in the SOP.

Material Details *

Provide any additional details that the Nanofab Staff should know regarding this request. Specifically, if the request is for a device, sample, substrate, etc. that includes multiple layers or materials, describe ALL layers, elements, and materials that are present. Enter N/A or None where no additional materials are present.

Is this material being used as a substrate or does it form a layer/film (excluding photoresist) on the sample? *

Yes

No

If this material is not a photoresist and will be processed in ANY equipment other than spin coaters or aligners, select "Yes".

ALL Nanofab equipment and processes to be used on sample: *

Please describe/list ALL Nanofab processes and equipment to be used on the sample between the time the material is introduced to the Nanofab and removed from the Nanofab.

Secondary chemicals or materials to be used with the new material

This list should only include chemicals or materials currently authorized for use. All non-authorized materials require a separate request form.

For each process in which this material is exposed and reactive, list the primary reaction products (chemical name) and their state (solid, liquid, vapor, plasma) as well as their exit or disposal route. *

Additional Information

Include any additional information to support this request.

GHS Information

Pictograms

Explosive

Compressed Gas

Oxidizer

Flammable

Toxic

Corrosive

Environmental Hazard

Health Hazard

Warning

Upload NMR Committee Review Powerpoint

File Upload

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Maximum file size: 419.43MB

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