User Application Form

User Application Form

User Application Form Instructions

We ask that your form be filled out using MS Word, but the Adobe Acrobat PDF format is available for those without MS Word. The PDF UAF may be filled out on-line and printed out. If possible, submit two copies; one electronic via e-mail to and another signed hard copy to:

Nancy Denslow
University of Florida
Center for Environmental & Human Toxicology
Box 110885
Gainesville, FL 32611

When filling out the application form please add as much information as possible. This includes full chemical names and any data available on the experimental chemical(s) to be used or similar compounds. Contact the facility manager for aid in gathering information or search in the following web sites (as more searchable sites are found they will be added to list):

Section I.
Principal investigator. Add the principal investigator’s name, address and telephone number

Section II.
Contact person(s). List the person(s) responsible for day to day operations of experiment and/or emergency contact person(s). Include name, address and phone number.

Section III.
Project and protocol description. Include IACUC approval number and a short description of your experimental protocols to be performed with in the facility. Important items to include are title of experiment, species of experimental animal, number of animals, size of animals, chemicals used/when/ and method of use.

Section IV.
Chemicals to be used. List chemicals to be used, concentrations and route of administration used during the experiment.

Section V.
Chemical Hazard Information. List any acute toxicity data available, MSDS, mammalian LD-50 data and references. Include any carcinogen data and references if applicable.

Section VI.
Water quality criteria. List the Florida Max. Contaminant Level (MCL) for drinking water standards for all chemicals used in experiment or a similar compound that may be used a surrogate. Also include if and how the chemicals used in the experiment will be removed from the effluent.

Some specific water quality information is also required that includes, total amount of toxicant to be released throughout the experiment, What is the water flow through the entire facility (contact lab manager for this information) and what is concentration of experimental chemical(s) in the effluent from the entire facility.

Section VII.
Tanks/facilities to be used. List what tanks or space is to be used during the experiment along with date animals will be first stocked and date they will be removed.

Section VIII.
Supporting information. Add any additional information that you feel necessary such as removal methods, other surrogate compound data and references.