ASRC Information and Guidelines

APPLICATION FOR ANIMAL HOUSING IN HOGAN EXPERIMENTAL ANIMAL LABORATORY (ASRC UNIT B)

ANNUAL* & SHORT TERM** USE

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1. Requesting:

ASRC User Fee Rates

Dates Needed: From: m 1 2 3 4 5 6 7 8 9 10 11 12 d 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 y 2009 2010 2011 2012 ------- To: m 1 2 3 4 5 6 7 8 9 10 11 12 d 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 y 2009 2010 2011 2012

Room Type	Preferred Room # (if known) ***	Species	Protocol #	# Animals	# Cages
Basic Animal Room Isolation Cubicle Environmental Chamber
Basic Animal Room Isolation Cubicle Environmental Chamber
Basic Animal Room Isolation Cubicle Environmental Chamber
Basic Animal Room Isolation Cubicle Environmental Chamber
Basic Animal Room Isolation Cubicle Environmental Chamber
Basic Animal Room Isolation Cubicle Environmental Chamber

2. You Must Attach a copy of the signed protocol to an email to Cyndi Jennings. 
3. Account Code to be Charged: MoCode #
4. Animals will be obtained from (Source):
5. If animals will be brought from another facility on campus a signed “Animal Transfer” form obtained from the Office of Animal Resources must be sent to Cyndi Jennings before this application will be considered.  Furthermore, for biosecurity reasons the movement of animals within the Unit must be approved by the facilities manager.

*ANNUAL ASSIGNMENT PERIOD OF OCTOBER 1 THROUGH SEPTEMBER 30.
**SHORT TERM ASSISGMENTS ARE NOT MORE THEN EIGHT WEEKS IN DURATION.
***ROOM REQUESTED OR CURRENT ROOM OCCUPIED

****PLEASE ALLOW AT LEAST 10 BUSINESS DAYS FROM THE DATE OF THE REQUEST TO THE DATE ROOM WILL BE NEEDED.

6. Please check the following facilities or service areas needed during the assignment period.

Autoclave

Feed & Bedding Storage (N188)

Surgery Room (N176)

Refrigerated/Freezer Storage

Service Rooms (Rm. 126/N165)

Diet Preparation (N158)

Other

7. Environmental Conditions Needed:

Desired temperature range °F to °F

Desired humidity range % to %

Desired Lighting: On at 1 2 3 4 5 6 7 8 9 10 11 12 00 15 30 45 am pm Off at 1 2 3 4 5 6 7 8 9 10 11 12 00 15 30 45 am pm
Daily Other

8. Authorized personnel and Emergency Contact: 

   Persons to contact in case of emergency:

   Name Title Phone#
   
   Name Title Phone#

   Persons authorized to work with the animals in animal room(s) (Must be included in Protocol):

   Name		Title
   Name		Title
   Name		Title
   Name		Title

You must agree to these terms. Investigator agrees that procedures outlined in "Unit B Small Animal Research Facility Standard Operating Procedures" will be reviewed with and followed by all personnel prior to their use of assigned space in the facility.

You must agree to these terms. By checking this box the investigator indicates that they have read and understand the GUIDELINES FOR HANDLING SOP VIOLATION IN THE ASRC.”

Note: Projects utilizing isotopes or infectious agents in Unit B animal rooms must obtain and attach a copy of the approval from MU Health Physics Services or the Institutional Biosafety Committee, respectively.