318-GM RAs proposal - GMSC Feedback Form (1/02/10)
1
Final Risk Class:
____________
1
GM Committee Ref:
____________
1
Biol. Services Ref:
____________
HSE Ref (if appropriate): 1___________
1
= all to be allocated by GM-BSO
GMSC FEEDBACK FORM
Title of Proposal:
Sub-title:
Name of Principal Investigator (PI):
Contact details for PI (‘phone/e-mail):
Name of Assessors:
Reasons for recommendation or declining of proposal/amendment:
Final assignment of containment measures and risk class:
Signed: ……………………………………….
Printed: ……………………………………..
On behalf of GMSC-318
Dated
On completion, this form should be sent to the Centre GM-BSO where he/she is not the sole assessor for
distribution to the project PI.
For Class 2, Notifiable and above:
Date HSE notified:
Date approved by HSE:
Comments from HSE attached on a separate sheet (yes / no):
Acknowledgements: Dr. John Coote, Feb. 2009
1
318-GM RAs - Project Amendment Form ((1/02/10)
1
Final Risk Class:
____________
1
GM Committee Ref:
____________
1
Biol. Services. Ref:
____________
HSE Ref (if appropriate): 1___________
1
= all to be allocated by GM-BSO
PROJECT AMENDMENT FORM
Please indicate below changes to the current proposal.
Project reference number to which amendment relates:
________________
Name of Proposer (required field):
Project title (required field):
Location of Laboratory work:
No change required
Location of Animal work (if applicable):
No change required
General description of procedures involved in the project:
No change required
Host system(s):
No change required
Add
Delete
Vector system(s):
No change required
Add
Delete
Inserts:
No change required
Add
Delete
Staff involved:
No change required
Add
Delete
Changes affecting the answers to the questions on the original proposal:
Do these changes affect the classification of the GMM?
Yes | No
Do these changes affect the risk assessment for human health?
Yes | No
Do these changes affect the environmental risk assessment?
Yes | No
If the answer is yes to any of these questions, the GMSC must be consulted before proceeding.
If the project has now ceased, please tick ______ and sign and date this form
Signature of proposer: ...............................................................
Date …………………
If you have any questions about filling in or submitting this form, please contact the Centre GM-BSO
Acknowledgements: Dr. John Coote, Feb. 2009
1