TITLE:	ES&H Manual
DOCUMENT ID:	3130 Appendix T1 FEL Experiment Safety Approval Form Instructions

1.0 Purpose

This form ensures that procedures, technical requirements of the experiment, and the actual work performed; are coordinated and performed safely.

For subsequent experiments that use base equipment that has already been established, reviewed, and approved, the original ESAF need only be amendment to include any changes to materials, operating parameters, etc. The same rigor of review and approval will apply, as if the document had been written as new.

2.0 Scope

For subsequent experiments that use base equipment that has already been established, reviewed, and approved, the original ESAF need only be amendment to include any changes to materials, operating parameters, etc. The same rigor of review and approval applies, as if the document had been written as new.

The process steps for this procedure are performed in coordination with ES&H Manual Chapter 3130 Free-Electron Laser Experiment Review Process.

3.0 Responsibilities

NOTE: Management authority may be delegated at the discretion of the responsible manager.

3.1 Lead Scientist – The designated spokesperson for each experiment.

· Develops an Experiment Safety Approval Form (ESAF), as required, and submits it for review and approval to the FEL Basic Research Program Manager.

3.2 FEL Basic Research Program Manager

· Assigns appropriate Subject Matter Experts to review identified hazard issues and mitigation techniques.

· Reviews and, if acceptable, approves the experiment’s ESAF. (Prior to approval submits the ESAF document to appropriate subject matter experts for reviewed and acceptance.); and distributes the approved document as appropriate.

3.3 FEL Facility Manager

· Reviews and, if acceptable, approves the experiment’s ESAF before authorizing beam to users. (Prior to approval ensures appropriate subject matter experts have reviewed and accepted the document.)

3.4 FEL Laser System Supervisor

· Reviews and, if acceptable, approves the experiment’s ESAF before authorizing beam to users. (Prior to approval ensures appropriate subject matter experts have reviewed and accepted the document.)

4.0 Process Steps

FEL Experiment ID Number – Contact the FEL Basic Research Program Manager. A unique number will be provided to you.

Number 1 through 6 - Introduction:

Provide the basic experiment and contact information requested.

The next two steps are to be performed by Jefferson Lab Staff:

Step 1: Supplemental Technical Validations:

Jefferson Lab requires that the information provided on this form be reviewed and approved by Subject Matter Experts (SME) to ensure:

· The safety of people, equipment, and the environment; and

· Compliance with applicable City, Sate, and Federal laws.

Often experiments involve hazard issues in addition to lasers. Those who approve this form are to determine the additional SMEs that need to review and accept that hazard issues are adequately addressed.

Step 2: Approval Signatures:

Upon completion of the form, the Lead Scientist submits it to the FEL Basic Research Program Manager for review and, if acceptable, approval.

Number 7 – Experiment Overview:

· Provide a brief description of the planned activities, including the approximate duration.

· If the experiment involves modification(s) to the basic optical beam delivery system then describe the modification(s).

Number 8 – Task Hazard Analysis:

No work at Jefferson Lab is completely without risk; therefore, all work, including experiments, requires forethought, planning, and authorization. The Basic Research Program Manager will use the information provided to determine the appropriate Subject Matter Experts who will provide the supplemental technical validations.

· Instructions: Answer all the questions. When answers indicate a hazard may exist – document your resolution(s) and hazard mitigation techniques.

Number 9 – Experimental Details:

· List all materials (and quantities) to be used in the experiment (include chemicals, gases, sample material, etc.)

· Describe any airborne contaminants that may be produced. Include its expected composition/decomposition; the method of exhaust; fixture description; and expected interaction with the FEL beam.

· Describe the beam stop construction and its ability to handle power.

· List the personal protective equipment required.

· Provide any additional precautions that will be taken to ensure personnel, equipment, and environmental safety.

Number 10 – Additional Laser Usage:

Describe any additional lasers used in the experiment. Jefferson Lab has determined that Class 3 and Class 4 laser light poses an unmitigated Risk Code>2; therefore, in accordance with ES&H Manual Chapter 3210 Work Planning, Control, and Authorization Process, a separate work control document is required for any additional or alteration to equipment or system. (See ES&H Manual Chapter 6410 Appendix T1 Laser Operational Safety Procedure.)

Number 11 – Outline Experiment Procedures:

· Provide a layout of the equipment and room set-up. (Include a brief description of any special requirements and/or overhead floor plan.)

· List the general experiment procedures to be used. (Please be concise. Provide sufficient information to illustrate what will be done, who will do it, and where procedures will occur. You may refer to the particular lab’s LOSP, its hardware, and procedures. However, a specific Test Plan for your experiment will be required after technical and safety approvals have been received and scheduling has been assigned.)

· Residual Hazards (Contaminants, Disposal, Safe Disassembly, …)

· Other Safety Considerations (Heavy Equipment, Industrial Hazards, Effluent, Electrical Safety, …)

Number 12 – Regulatory Requirements:

Certain biological, radioactive, and chemical materials can be extremely hazardous and are strictly regulated. Jefferson Lab is required to enforce these regulations and has developed additional procedures to ensure the safety of its people, equipment, and the environment. Full disclosure, so mitigation can be established, will expedite this experiment safety approval process.

Number 13 – Environmental Management Information:

(See EMP-04 Project/Activity/ Experiment Environmental Review)

· If this is a water-based project provide details.

· If the experiment will generate waste, provide anticipated quantities and disposal methods.

Number 14 – Decommissioning/Shutdown Procedure (if necessary):

Provide guidelines or process steps which outline closeout actions to will ensure the laboratory is left in a safe and clean state after the experiment.

Submit the completed form to the FEL Basic Research Program Manager for review and approval.

5.0 Revision Summary

Revision 1.1 – 11/12/08/10 – Updated link to LOSP.

Revision 1 – 11/23/10 – Updated to reflect current laboratory operations.

ISSUING AUTHORITY	TECHNICAL POINT-OF-CONTACT	APPROVAL DATE	EFFECTIVE DATE	EXPIRATION DATE	REV.
ESH&Q Division	George Neil	11/23/10	11/23/10	11/23/15	1.1

This document is controlled as an on line file. It may be printed but the print copy is not a controlled document. It is the user’s responsibility to ensure that the document is the same revision as the current on line file. This copy was printed on 12/9/2010.