ISD GIF Form

ISD GIF ++

First

Last

Do you have a CERN phone number ?

Yes

CERN Phone Number

Other Phone number (including country code)

Setup Responsible E-mail

Experiment Safety Contact E-mail

Technical Coordinator E-mail

Other E-mail(s)

IMPACT LINK (URL)

Installation Start date

Dismantling End date if known

Operation Start Date

Operation End Date

Building Number

887

Counting Room

B.887/1-R87

The EP Safety Office is available during normal CERN working hours for test beam safety inspections (i.e. Monday to Friday between 8 am – 6 pm)

Note: For EP safety clearance visits in GIF++, there is a block of time each week between 15:00 and 17:00 every Wednesday to speed up the clearance process. Ideally, we will schedule all GIF++ safety clearance visits within this time window.

There may be exceptions when an earlier/later inspection of your setup is required for technical reasons. If your installation in GIF++ will not be available for a safety clearance in the preferred window, please request a date/time when your setup will be complete and we will contact you to confirm the inspection schedule.

Safety Inspection Request Date

Requested Time

Setup Name

Description of the setup

Please upload your layout

Choose File

Please identify the hazards involved in the experiment and provide further description information on this hazards (ex: Cyogenic fluid, Volumes, Pressures, Voltages…)

Additional Information

Mechanical Safety

Pressure

Are you bringing equipment to CERN which operates at a nominal pressure of more than 0.5 bar above atmosphere.

Yes

Do you have a CE certificate or technical documentation for the equipment?

Yes

Please upload pdf

Choose File

Contact EP Safety office for evaluation

Please provide details

Vacuum

Are you bringing your own vacuum vessels to CERN?

Yes

Do you have any technical documentation (CE certificate, engineering drawings, calculation note…)?

Yes

Please upload pdf

Choose File

Contact EP Safety office for evaluation

Please provide details

Lifting Equipment

Using DESY tables or other lifting equipment provided by CERN does not need to be declared here.

Will you be bringing your own custom lifting equipment to CERN?

Yes

What type of equipment is it?

Lifting tool (i.e. a spreader beam used to carry equipment)

Lifting table (i.e. an elevating platform)

Other

Type of lifting tool

Do you have a CE certificate?

Yes

Please upload pdf

Choose File

What is the rated load of the equipment ?

Mechanical energy from moving parts

(i.e. detector on rails which is moved manually, or hinged element which is moved by hand)

Yes

Description

Mechanical properties (sharp, rough, slippery)

Yes

Description

Site installation

Use of …

Hot Work (e.g. welding, grinding)

Scaffolding

Ladders (Ladders are generally forbidden, but PIR and mobile access platforms may be used)

Powered access equipment (MEWP, cherry picker/nacelle etc.)

Please provide details

General Risks

Use of chiller

Yes

Refrigerant

Water

Others (water/glycol mix, ethanol, R134a etc.)

Please provide safety data sheets for chemical product

Choose File

Please provide details

Working outside normal working hours (Note: Lone working is subject to a safety assessment)

Yes

Please indicate the periods of activity and the proposed shift lengths?

Radioactive Sources

Yes

Please indicate the type and inventory number (ID) if it is already known. Otherwise, the ID will be requested during the inspection

Non-Ionizing Radiation Safety

Radio Frequency

Yes

Please state the frequency and power level

Laser

Yes

Which class (up to class 3 and class 4 require approval by the EP Safety Office)

UV Light

Yes

Please state the wavelength and power level

Magnetic field

Yes

Please specify the type of field used

Permanent magnet, provide field map

Electromagnet, please specify nominal voltage and current

Superconducting magnet, please provide technical documentation, certification, etc…

Téléchargement de fichiers

Choose File

Téléchargement de fichiers

Choose File

Please provide details

Electrical Safety

High Voltage (>1000V)

Yes

Please indicate voltage levels which will be used (e.g. 2000V, 4500V etc.)

Cryogenic Safety

Cryogenic fluid

Yes

Cryogenic details (type of cryogen, quantity, pressure, details)

Will you be using a cold head system

Yes

Please provide details (use – e.g. germanium detectors, type of cryogen and quantity required)

Use of gases

Will you use gases for your experiment?

Yes

What type of gases

Flammable

Non-Flammable

Select how the gas is conditioned:

Premix containing flammable gas in a proprtion greater than the LEL, treated as flammable.

Pure flammable gas (e.g. Isobutane, Hydrogen etc.)

Mixture of flammable gas and non-flammable gas produced on site (i.e. in gas supply rack)

Is the gas supplied by CERN?

Yes

Téléchargement de fichiers

Choose File

Input SCEM code (starts with 60. or 61.)

Please provide the approximate flow rates or pressures you plan to use.

Non-flammable premix containing flammable gas (i.e. the quantity of flammable gas in the mixture is below the Lower Explosive Limit – LEL)

Yes

Non-flammable is it supplied by CERN?

Yes

Please provide safety data sheets for the gas/gases used

Choose File

Applicable gas from CERN stores for the following gases:

Argon

CO2

Nitrogen

Other: Please input the SCEM code – valid entries begin with 60. and 61.

Please provide the approximate flow rates or pressures you plan to use.

Chemical Safety

Use of chemical products (e.g. Beryllium, ethanol, glycol, solvents etc)

Yes

Please provide the SDS

Choose File

Type of chemical

ISD – Initial Safety Declaration

This document shall be completed by the Experiment Safety Contact of an experimental collaboration, whenever it intends to bring new experimental apparatus, new test beams or make major modifications to experimental apparatus already operating at CERN.

The purpose of this document is to provide a summary description of the equipment that is to be brought to CERN and the activities that are to be carried out. This document will then allow the EP Safety Office (EP-SO) to perform an initial safety assessment; i.e. identification of the applicable safety requirements, control measures, etc.

This ISD document will serve as a basis for the safety information on an experiment. Further documentation may be requested to improve the understanding of safety hazards.

Recommendations and procedures will follow after the provision of this document. Note that if the experiment is considered to have major safety implications then the CERN HSE unit will become involved and their safety procedures will then be followed.
A Launch Safety Discussion may be called by the EP-SO. This will take place on site with representatives of the experiment, EP-SO, the HSE Unit and other CERN Departments.
A formal ‘Safety Clearance’ of the experiment must be given prior to the experiment being allowed to start operating (for example to receive beam).

This form must be completed and sent to CERN prior to the arrival of the planned experiment. Work will not be allowed to start until this form, and any requested complementary information on safety hazards, has been completed and handed over as explained above.

Please note that the safety video “Safety for EP Temporary/Small Experiments in East Hall – B.157 and North Area” must be watched to validate this form.

I confirm that I have watched and understood the mandatory safety video “Safety for EP Temporary/Small Experiments in East Hall – B.157 and North Area” and I commit to communicate this video to my team members. I further commit to take all necessary measure to ensure compliance by my team with the applicable safety rules and procedures including the requirements for Personal Protective Equipment (PPE). I understand the possible consequences in case of non-compliance.