Equipment Commissioning Form Number/Rev #

Checklist EHS-00017-F1 R23

Date of
Applicant:      
Commissioning:
Name of Organization:      
Tool Owner:      
/ /
                 

Tool Identification Equipment Description

Tool ID Code:            
Tool Name:            
Supplier:            
Model:            
Equipment Status
New - anticipated arrival date -       /       /      
Relocated (equipment must be decontaminated) - from other location
from within SUNY Polytechnic Institute (SUNY Poly) CNSE Facilities
Change to Existing Installation (only complete sections that apply)
Description of Change(s):
     

Code
Responsible Parties Full Name Initials Phone #
(R)
Installation Coordinator
IC                  
Tool Owner
TO                  
Tool Engineer/
TE/EE                  
Equipment Engineer
SUNY Poly CNSE
Environmental, EHS                  
Health & Safety

This checklist is for use in approving the completed installation of tools using Hazardous
Production Materials (HPM) and equipment for commissioning to be used in the SUNY
Poly CNSE Facilities. The checklist is divided into two (2) parts. Part 1 covers the electrical,
mechanical, non-HPM chemicals and facilities release. Part 2 covers the release of all
Hazardous Production Materials and Physical Hazards for tool/equipment operation. This
checklist must be completed prior to releasing the tool/equipment to the tool owner for
process transition and operational use.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 1 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

PART 1 EQUIPMENT COMMISSIONING CHECKLIST

Electrical & Mechanical Activation, Non-HPM Chemicals and Facilities Release
In some cases electrical energy must be supplied to execute portions of the Part 1 Checklist. Necessary
electrical power circuits may be released from LOTO, following approval from SUNY Poly CNSE Facilities
EHS, in order to check proper operation of these subsystems. The circuits must then be returned to a
LOTO state until Part 1 is approved.

When the Part 1 Checklist is fully and successfully completed, all electrical power, vacuum, non-HPM
chemical and water facilities may be activated. All other systems associated with the tool/equipment (i.e.
physical, HPM chemical, radiation, or other hazards) must remain completely locked out until installation
is complete and the Part 2 Checklist is approved.

A. Electrical Matrix
N/A
List all sources of electricity to the tool/equipment (IC)
Name of Panel / Feeder Voltage (V) Breaker
Current Lockable
List Tested & Phase Size
(A) Disconnect?
Voltage Verified? (A)
                                   
                                   
                                   
                                   
                                   

N B. Electrical Safety Requirements IC TE/EE EHS

/
A
1. Ground continuity has been verified. (Ground/bond straps installed & verified,
where applicable)
2. The facility power network from the distribution or branch panel to the tool main
disconnect has been verified for correct connections and labeling.
3. Lockable main power disconnects are readily accessible, properly labeled, and
capable of disconnecting all electrical power sources to the machine.
4. Electrical wiring/equipment is protected from probable liquid leak sources.

5. A Ground Fault Circuit Interrupt (GFCI) system is installed & operating per design,
where applicable. N/A
6. If installed in hazardous classified locations or exposed to flammable vapors, all
electrical components are rated for hazardous locations in accordance with ICC
Electrical Code class, group & division per design.
7. Is the tool connected to an Uninterruptible Power Supply (UPS unit & tool labeled
accordingly)? Yes No
8. Are all support systems (i.e. vacuum pumps, chillers, etc.) fed from the tool or
sub-panel properly connected and labeled?
9. The following items are labeled correctly and clearly. (labeling requirements in
parentheses)
a. Main power disconnect (On/Off, tool ID(s) that it supplies, voltage, phase,
current, supply circuit #, location / ID of supply sub-panel)
b. Supply electrical sub-panel (tool identification that it supplies)
c. All tool disconnects (On/Off, tool ID(s) that it supplies, voltage, phase, current,
supply circuit #, location / ID of supply sub-panel, type of power [e.g. Normal,
UPS]).

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 2 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N B. Electrical Safety Requirements IC TE/EE EHS

/
A
d. Convenience outlets (circuit breaker #, panel #). N/A

e. Tool status indictors (i.e. light trees).

10. All unused openings in electrical panels or enclosures are properly closed.
11. Are any breakers installed adjustable? Yes No
a. If applicable, list sizes:      
     
     
b. Breaker(s) have been set according to SUNY Poly CNSE set points.

N/A Cord & Plug

C. Lockout/Tagout and Hazardous Energy Control IC TE/EE EHS
N/A
1. Lockout / Tagout (LOTO) procedures have been developed specific to this
equipment and included in the Greenbook.
2. Readily accessible (as defined in the SEMI S2 standard) means are provided for
isolation (LOTO) of all hazardous energy sources (mechanical, pneumatic,
hydraulic, chemical, radiation, etc.) & all isolation points are identified and
documented.
3. Prior to Part 1 sign-off, all hazardous energies are completely locked and tagged
out.
4. The activation of any Part 1 (non-HPM) utility (e.g. electrical) has been verified to
ensure that installation personnel will NOT be exposed to hazardous conditions
during remaining installation activities. If not, please describe. ↙ N/A
Notes and Comments:      

D. Access and Clearance Requirements IC TE/EE EHS

1. The minimum work space clearance in front of electrical equipment that is likely to
require examination, adjustment, servicing, or maintenance while energized is
compliant with NEC. (36" for < 150 V or 42-48" for 150-600 V, depending on NEC
conditions).
2. The width of the working space in front of electrical equipment is the width of the
equipment or 30 inches, whichever is greater (NEC).
3. There is a minimum of 80" clear headroom in electrical workspace per NEC.

4. There is a 36" horizontal servicing clearance for HPM workstations (per NYSFC
1805.2.2.3).
5. All exterior doors and access panels warn of the hazards located behind them.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 3 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N E. Lasers N/A TE/EE EHS

/
A
List Type & Quantity: Class 1       Class 1M       Class 2       Class 2M      
Class 3R       Class 3B       Class 4      
1. A label is visibly present on the outside of the tool, certifying compliance with FDA
-CDRH requirements (21 CFR 1010.2).
2. Equipment containing lasers is labeled per ANSI Z136.1 & per 21 CFR 1010 & 21
CFR 1040.10.
3. All laser interlocks are functional and the Activation Warning System is operational
as required.
4. Is there a protective housing around the laser? Yes No

5. All removable service access panels are either interlocked or require a tool for
removal.
6. All viewing portals attenuate to class 1 or 2.

7. Is there open beam exposure potential to class 3B or 4 Lasers? Yes No

If yes, complete the form: EHS-00048-F1, Requirements for a Class 3B or 4 Laser.
8. All Lasers have been added to the SUNY Poly CNSE Facilities Laser Inventory
(EHS-00066-F5) and reviewed by the SUNY Poly CNSE Laser Safety Officer.

N/A F. Radiation Requirements N/A TE/EE EHS

1. Hazardous UV light sources are enclosed, interlocked and properly labeled.
2. Sources of strong magnetic fields (>5 gauss) are properly labeled with pacemaker
hazard, field strength and hazard distance.
3. All RF & microwave sources have been identified and properly labeled.
4. All sources of ionizing and non-ionizing radiation have been reviewed by SUNY
Poly CNSE Radiation Safety Officer?
5. If X-ray sources are present, the sources are enclosed, interlocked and properly
labeled.
6. The power supply to all radiation sources (ionizing and non-ionizing) is locked /
tagged out and all shielding is in place. (NOTE: Radiation sources will not be
energized prior to Part 2 sign-off).
7. All sources of ionizing radiation have been added to the SUNY Poly CNSE EHS
Radiation Device Inventory (EHS-00066-F2).
Radiation Sources (TE)
Check all that apply Frequency and/or Wavelength Maximum Power Properly Labeled?
RF / Microwave             Yes No
Ultraviolet             Yes No
Infrared             Yes No
X-Ray             Yes No

G. List All Utilities (Non-HPM Gas &/or Liquid, Chiller, Process Vacuum, CDA, Water, Facility Lines,
N/A
or Natural Gas Lines, etc.) Needed For Part 1 Sign-off
Utility Needed Labeled? Leak Checked? Comments:
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 4 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

      Yes No Yes No      

      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
      Yes No Yes No      
IC TE/EE EHS
1. All non-HPM gas &/or liquid, chiller, PVAC, CDA, water, facility lines or natural gas
lines, etc. are clearly labeled (contents & direction of flow) at every change of
direction, before & after every structural penetration, and at regular intervals
according to SUNY Poly CNSE Facilities guidelines.
2. All non-HPM gas &/or liquid, chiller, PVAC, CDA, water, facility lines or natural gas
lines, etc., supplying non-HPM materials, have been pressure/leak checked and
documented (if applicable).

H. Onboard Non-Process Chemical Inventory

N/A To be filled out by Tool Engineer. List all chemicals such as refrigerants, coolants, additives,
pump lubricants, etc. used in the tool or its peripherals.
Loop / Tank (check
Manual SDS Received Approval
Chemicals Used & Concentration box)
Fill? Submitted from EHS?
(full chemical name) Closed Volume
Yes / No Tank (mm/dd/yyyy) Yes / No
Loop (gal)
                 
                 
                 
                 
                 

N/A I. Guarding IC TE/EE EHS

1. All electrical, thermal, and mechanical hazards (i.e. pinch-points, moving parts,
etc.) are properly guarded and labeled.
2. All robotics envelopes are adequately defined and guarded. N/A

N J. Personal Protective Equipment IC TE/EE EHS

/
A
1. Proper PPE is available for all operations & maintenance tasks associated with this
equipment. Please list:      
2. Proper PPE storage is available.

N K. Tool Identification IC TE/EE EHS

/
A
1. The proper tool identification with primary and secondary Tool Owners is listed and
posted.
2. The tool matrix has been updated and submitted to SUNY Poly CNSE EHS.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 5 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

3. If the tool installation alters the layout of the cleanroom space, a new evacuation
map has been submitted to SUNY Poly CNSE Facilities EHS.
N/A

N/A L. Seismic Restraints IC TE/EE EHS

1. Seismic bracing and anchoring designed utilizing the following data:
1) Seismic Use Group: II; 2) Seismic Design Category: D; 3) Spectral Response
Coefficients: a. Sds = 43.85 (%g); b. Sdl = 21.14 (%g); 4) Site Class: E; 5) Basic
Seismic Force Resisting System: Dual System Special Reinforced Moment Frame
With Special Reinforce Concrete Shear Walls; 6) Design Base Shear: V = 2560
KIPS; Analysis Procedure: Equivalent Lateral Force Procedure.

N/A M. HPM Delivery System (Liquids and Gases) IC TE/EE EHS

1. Output delivery lines/sticks exiting from supply unit and/or components.       (write
in number)
2. Chemical/Gas Services process control locks applied to each of the output
lines/sticks.       (write in number of locks applied)
3. Tool Installation process control locks applied to each of the output lines/sticks.
      (write in number of locks applied)
4. EHS process control locks applied to each of the output lines/sticks?       (write in
number of locks applied)

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 6 of 20

 Equipment Commissioning Checklist EHS-00017-F1 R23

N/ N. TGMS Controls & Matrix IC TE/EE EHS

A
1. The TGMS Engineer has reviewed and approved the location(s) of the installed
TGMS device(s) for serviceability.

Part 1 Punch List

List all deficiencies that do not affect the safety of the installation. A Punch List item may not compromise safety.
Punch List items must be completed prior to Part 2 sign-off.

Issue Responsibility Completion Date

1.                  
2.                  
3.                  
4.                  
5.                  
6.                  
7.                  
8.                  
9.                  
10.                  

Notes and Comments

     

Part 1 Interim Sign-offs N/A Signature Print Name Date

1a) EHS: Electrical Power: Debug                  
1b) EHS: Non-HPMs                  
2a) System Owner: Process Vacuum                  
2b) System Owner: Compressed Dry Air                  
3a) System Owner: Ultra Pure Water                  
3b) System Owner: Process Cooling Water                  
4a) System Owner: Bulk Gases/Non-HPMs                  
5a) System Owner: Bldg. Electrical Power                  
6a) System Owner: TGMS                  

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 7 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

Part 2 Equipment Commissioning Checklist

Release of all Hazardous Production Materials & Physical Hazards for Engineering Use
A. General N/A TE/EE EHS
1. The ERT Coordinator has been informed of the equipment installation and become
familiar with its emergency shutdown procedures.
2. Final Approval / Sign Off of the Part 2 Inspection by EHS is contingent upon the
completion of the following two steps:
a. Procedures concerning new or unusual hazardous processes or materials
have been documented and training provided to an ERT Leader or Alternate
Leader on all four shifts
b. An ERT Leader or Alternate Leader from each shift must acknowledge
(through their signature below) that they have been provided with a physical
tour of the newly installed equipment. This tour must include an overview of
emergency features (EMO’s, Gas Detector Locations, Interlocks, Smoke
Detection, Fire Suppression Systems…)
Day 1 ERT Leader:
Day 2 ERT Leader:
Night 1 ERT Leader:
Night 2 ERT Leader:
3. Are there any additional hazards, equipment or conditions that the ERT need to be
trained on? Yes No
a. If applicable, a SOP has been developed to cover this training.

b. If yes, training has taken place for each shift?

D1 Yes No N1 Yes No D2 Yes No N2 Yes No
4. A process has been developed for entering a confined space associated with the
tool's operation or maintenance.
5. The S2 noise survey verified that the equipment operates at <80 dBA. If not, a field
survey has been completed to determine impact to the area.
6. The work area is adequately illuminated.
7. HPMs (and HPM byproducts) have been updated in the gas/chemical matrix
maintained by SUNY Poly CNSE Equipment Engineering team.
8. List any specially negotiated working conditions.

Notes and Comments:      

N/A B. Exhaust Ventilation (IC)

Type:
Location scrubbed, Flow Monitoring Devices Set Points
List all exhaust outlets heat Type and Location Labeled
solvent, etc.
                  Yes No
                  Yes No
                  Yes No
                  Yes No
                  Yes No

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 8 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N/A C. Exhaust Ventilation Requirements IC TE/EE EHS

1. All exhaust ducts are labeled with contents and direction of flow at every change of
direction, before & after every structural penetration and at regular intervals
according to SUNY Poly CNSE Facilities labeling guidelines.
2. A ventilation test and balance has been completed and submitted to EHS and all
dampers are marked and locked.
3. All ventilation systems that handle HPMs have continuous monitoring devices (i.e.
photohelic, magnehelic, etc.) installed. N/A
a. Are all monitoring devices in the plenum functional, secured, properly set &
labeled with set points?
b. Are all monitoring devices at the tool functional, secured, properly set &
labeled with set points?
4. Blast gates on all ventilation systems are locked?

5. A loss of exhaust test has been performed to verify that the tool is placed in a safe
condition upon loss of exhaust ventilation flow? N/A
6. Industrial Hygiene Ventilation Assessments (capture velocity) has been completed
for all areas where hazardous chemicals may be exposed to the open environment
(i.e. wet stations, lab hoods, wet chemical dispense cabinets, etc.). N/A
7. Local exhaust systems are provided for maintenance activities. If so, please
describe.       N/A
Notes and Comments:      

N D. Vacuum Pumps IC TE/EE EHS

/
A
1. All inputs and outputs are labeled with direction of flow and all lines are adequately
secured?
2. The vacuum pump rotation has been verified.

3. All vacuum Pump EMOs and interlocks are functional (e.g. nitrogen purge, back-
pressure, temperature, cooling water flow) and documented.
4. All vacuum pumps that convey toxic gases are contained within an exhausted
enclosure. N/A
5. All Nitrogen and water flow indication devices are functional.
6. Where applicable, the shaft seal nitrogen purges are operational. N/A

7. Exhaust piping is routed to prevent pooling of liquids. (no visible low spots or
sagging).
8. Appropriate measures have been taken to prevent back streaming into the house
nitrogen system?
9. For oil sealed pumps, list oil type:       N/A
a. The pump oil is compatible with the process materials? N/A

b. An oil drip pan has been installed under the entire pump package. N/A

c. An oil demister or separator is installed if required. N/A

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 9 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N D. Vacuum Pumps IC TE/EE EHS

/
A
d. The pump-case purge and or pump ballast purge are interlocked. (oil sealed
pumps) N/A

E. Local Dispense and Bulk Chemical Inventory

N/A
To be filled out by Tool Engineer. List all aqueous or solvent chemicals supplied to the tool.

Manual Bath or Tank (check one)

Chemicals Used & Concentration (%) Date Chemical
Pour?
(full chemical name) Bath Tank Volume (gal) Approved
Yes / No
                 
                 
                 
                 
                 
                 

N F. Local Dispense Chemical Delivery Systems Requirements IC TE/EE EHS

/
A
1. All chemical supply lines and containment piping are clearly labeled (contents &
direction of flow) at every change of direction, before & after every structural
penetration, and at regular intervals according to SUNY Poly CNSE Facilities
labeling guidelines.
2. All appropriate locations (tool, all support equipment, and chemical enclosures) are
labeled with point-of-use chemical labels and/or HAZCOM labels.
3. All chemical (HPM or otherwise) supply lines have been pressure and leak tested
and documentation has been submitted to EHS. Supply lines are double contained
where required.
4. All valves and fittings for HPM liquid delivery systems are contained within a
ventilated enclosure. N/A
5. Leak detection systems are adequately installed for the equipment and are in all
chemical valve boxes.
a. All liquid leak detection systems have been tested and verified to be operational
and have been documented.
b. All exhaust pressure detectors have been tested and verified to be operational
and have been documented.
c. If applicable all heat detectors have been tested and verified to be operational
and have been documented.
6. All pressurized chemical containers are equipped with the following: N/A

a. If pressurized to >15 psig, they are ASME rated and provided with over-pressure
protection.
b. If non-rated, containers are equipped with pressure relief devices set to a
maximum of 15 psig.
c. Vented to the system exhaust.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 10 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N F. Local Dispense Chemical Delivery Systems Requirements IC TE/EE EHS

/
A
d. Equipped with functional liquid level detection and overfill protection.

e. Bonding / grounding & provided with an inert pressurizing agent (for flammable
chemical containers).
7. All access areas to pressurized lines are shielded / interlocked to prevent potential
exposure to chemistries.
8. Safety showers / eye wash stations are located within 10 seconds travel or 50 feet of
chemical use or closer depending on the degree of hazard associated with the
chemical(s) used. (ANSI Z358.1-1990) N/A

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 11 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N G. Bulk Chemical Delivery Systems Requirements IC TE/EE EHS

/
A
1. All chemical supply lines and containment piping are clearly labeled (contents &
direction of flow) at every change of direction, before & after every structural
penetration, and at regular intervals according to SUNY Poly CNSE Facilities
labeling guidelines.
2. All appropriate locations (tools, all support equipment, and chemical enclosures) are
labeled with point-of-use chemical labels and / or HAZCOM labels.
3. All bulk chemical delivery lines and containment piping are attached to the correct
point of use and terminated at the tool. (no fittings within the double contained
piping)
4. All valves and fittings for HPM liquid delivery systems are contained within a
ventilated enclosure. N/A
5. Liquid leak detection is properly installed in all chemical valve boxes.
N/A
a. All leak detection systems have been tested and verified to be operational and
documented.
6. All HPM delivery lines have been verified to have secondary containment. N/A

7. All external and onboard HPM delivery lines have been leak tested and/or pressure
tested, documented, reviewed and accepted. N/A
8. All chemical valve boxes have been leak tested, documented, reviewed and
accepted.
9. The chemical valve box supply to the tool closes upon EMO activation from the tool.
10. All emergency HPM shutoff valves are clearly visible and indicated by means of a
sign. (NYSFC 2703.2.2.1.4) N/A
11. All flammable and combustible materials are sealed from electrical equipment or
ignition sources.
12. For new bulk chemical installations, the following information has been submitted to
the EHS department to calculate HPM allowances for each control area.
Chemical type/name:       # of cylinders:      
Size:       pounds/container OR       gallons/container
13. PLC communications systems have been properly:
a. wired and connected to the tool.
b. programmed & verified to send correct signals to the correct valves per design.

Gases Used & Concentration (%)

N/A Date Chemical Approved
(full chemical name)
           
           
           
           
           
           

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 12 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N H. Gas Delivery Systems Requirements IC TE/EE EHS

/
A
1. All lines have been traced to origin and verified.
2. Double contained lines (coaxial tubing) are in place as required. N/A
3. Coaxial tubing has been pressurized to 100 psig, with warning and alarm points set.
4. All gas lines are clearly labeled (contents & direction of flow) at every change in
direction, before & after every structural penetration, and at regular intervals
according to SUNY Poly CNSE Facilities labeling guidelines.
5. All gas-cabinets/VMBs are properly labeled with "tool destination labels".

6. All enclosures (e.g. gas cabinets, VMBs, GIBs, tool chambers, tool gas boxes) are
properly labeled with approved HAZCOM labels.
7. All leak points for HPMs are exhausted and / or fitted with gas detection per the
design. N/A
8. All gas delivery systems internal to the tool have been leak checked and
documented.
9. All gas delivery systems external to the tool have been leak checked and
documented.
10. Leak detection checklist(s) have been completed and submitted to EHS.

11. All valves and fittings on HPM gas systems are contained within a ventilated
enclosure per design. N/A
12. All gas cabinet vent lines are located after the blast gate, on a lateral or at least five
duct diameters downstream from a TGMS sensor.
13. PLC communications systems have been properly:
a. wired and connected to the tool.
b. programmed & verified to send correct signals to the correct valves per design.
14. For new gas cabinet installation, the following information has been submitted to the
EHS department to calculate HPM allowances for each control area.
Gas cylinder type:       # of cylinders:      
Size:       pounds/cylinder OR       cubic feet/cylinder
15. All liquefied gas properties and operating conditions have been provided for
assessment.
16. The cabinet set up has been adjusted to the liquefied gas operating conditions and
physical properties.

N I. Detection/Monitoring Requirements IC TE/EE EHS

/
A
1. Continuous detection has been installed at appropriate monitoring points per design.
(NYSFC 1803.13.1)
2. Each monitoring point has been checked to verify that upon activation, an automatic,
fail-safe source shutdown occurs and a visible / audible area alarm is initiated and
documentation of such has been submitted to EHS. (i.e. TGMS Matrix sign-off)
3. All detector points have been installed so that they are accessible and visible.

4. All detector points are adequately labeled and easily read.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 13 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N I. Detection/Monitoring Requirements IC TE/EE EHS

/
A
5. The gas detectors are positioned before the blast gate. N/A

6. The gas cabinet vent line has been placed at least 5 duct diameters upstream from
the gas detectors. N/A
7. Newly added detection points have been added to TGMS site summary and posted
at the TGMS touch screens. N/A
8. A map of the new detector locations is available and posted at the AAC. N/A

9. The completed and signed final TGMS matrix is attached and a copy has been
submitted to EHS.

N J. Drain Matrix
/
A
Material of Leak Checked Piping Labeled Properly
Drain System (TE)
Construction (TE) (if required) (IC) (IC)
                       
                       
                       
                       
                       

N/A K. Chemical Disposal Requirements IC TE/EE EHS

1. All drain piping are clearly labeled (contents & direction of flow) at every change of
direction, before & after every structural penetration and at regular intervals
according to SUNY Poly CNSE Facilities labeling guidelines.
2. All workstation drainage piping is connected to a compatible system so as to avoid
chemical reactions generating heat, gases, or dangerous by-products per design.
3. HPM drain lines are double contained where required.

4. HPM drain-lines are leak checked and documented.

5. All drain waste and vent piping have been tested for proper performance via
operation of the process equipment.
6. An operational plan is in place to prevent incompatible chemicals from being mixed.
7. Appropriate waste receptacles/containers/units are available in the work area and
properly labeled.
8. Segregated satellite collection locations are present and labeled as needed. (e.g.
arsenic or lead waste)
9. The workstation is provided with an approved means of containing or directing spills
to a drainage system per design (i.e. slope or other approved means of spill
containment). (NYSFC 1805.2.2.2)

N/A L. Post-Process Exhaust Treatment Systems (TE/EE Check all that apply)
Passive Dilution / Reaction Chamber Dynamic Neutralization Chamber (DNC)

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 14 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

Thermal Decomposition Unit (TDU) Wet Chemical Reactors

Dry Chemical Reactors Other:

Post-Process Exhaust Treatment Systems IC TE/EE EHS

1. The post-process exhaust treatment system is operational, and all interlocks are
functioning.
2. The process gas flow shuts down in the event of exhaust treatment system failure.
3. Upon activation of a trouble alarm, the system places the tool into a safe condition
and sends an alert via the TGMS or BMS.
4. The exhaust treatment system configuration allows access for inspection and
cleaning.
5. Is a fire sprinkler (wax coated, plastic bag, quick response) installed downstream of
the reaction chamber, at the transition to the main exhaust lateral per design? (Is
water drainage adequate?) Yes No
6. The post-process exhaust treatment system is labeled with HAZCOM labels or
similar labels identifying the process gas and corresponding by-products.
7. Post-process exhaust emission calculations have been submitted and approved by
EHS to ensure adequate exhaust treatment and posted on the treatment unit.

N/A M. Fire Detection (TE/EE check all that apply)

High sensitivity detection (Optical Air Sampling Smoke Detection, e.g. VESDA, HSSD)
Locations:      
Smoke Detection:      
UV / IR detection:      
Other:      

N N. Fire Protection Requirements IC TE/ EE EHS

/
A
1. Annunciation has been verified for all equipment-specific fire detection devices.

2. Equipment-specific fire alarm annunciation has been verified.

3. Lab hoods that use flammable / combustible liquids are serviced internally by a fire
sprinkler head and added to the SUNY Poly CNSE laboratory hood inventory.
N/A
4. For Wet Stations (all wet chemical processes), sprinklers are installed on the bay
ceiling in front and behind the tool, providing coverage to all areas of the tool. N/A
5. All workstations of combustible construction have a sprinkler head installed in the
exhaust duct / plenum within 2 feet of the point of the duct connection or the
connection to the plenum. (NYSFC 1803.10.1.1) N/A
6. Heat detectors/sprinklers are installed in all combustible ducts & non-combustible
ducts conveying vapors or gases in the flammable range (>10% LEL) that are ≥ 10"
in diameter. (NYSFC 1803.10.1.1) N/A
7. All fire suppression agent (e.g. sprinkler, CO2, etc.) delivery piping leading into
enclosed equipment has been pressure tested. N/A

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 15 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

N N. Fire Protection Requirements IC TE/ EE EHS

/
A
8. Fire sprinkler flow patterns within enclosed equipment have been verified to be
unobstructed. N/A
9. Fire suppression/detection systems are installed within enclosed equipment where
necessary and they have been tested and verified functional, providing the required
discharge density. N/A
10. All sprinklers that service the area occupied by this equipment are accessible for
periodic inspections.

N O. Local Fire Suppression/Detection System Documentation IC TE/EE EHS

/
A
1. The System has been certified & documentation submitted to EHS.

2. The System Manuals have been submitted to EHS.

3. The Local Fire Suppression/Detection System Summary Sheet has been updated.

N P. Emergency Machine Off (EMO) IC TE/EE EHS

/
A
1. The EMO turns off all electrical power to the system including the UPS (except non-
hazardous control voltage and power sources to safety related devices).
2. Upon resetting of the EMO, the equipment remains shutdown and requires a manual
re-start.
3. EMO buttons are located within 10 feet of all operating & scheduled maintenance
locations or where a physical barrier (wall, floor, panel, etc.) separates work locations
from the EMO button.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 16 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

Q. Interlocks
N Note: This section applies to all interlocks internal to the equipment. N/A TE/EE EHS
/
A
1. An interlock matrix (indicating what is activated or shutdown when each interlock is
activated) has been provided for each of the following interlocks.
a. Exhaust flow (e.g. photohelic)
b. Temperature / Fire Detection (e.g. over temp., UV Sensor)
c. Mechanical (e.g. pinch points)
d. Robotics and/or Automation (e.g. light curtains, IR Sensors)
e. Pneumatic / Hydraulic
f. Electrical (e.g. High Voltage, door panels)
g. Other      
2. All interlocks have been tested and verified to be operational as indicated on the
interlock matrix and such documentation has been submitted to EHS.
3. Have any changes been made to the tool or operating system that may have
affected the functioning of any interlocks? Yes No
a. If yes, all interlocks have been re-tested after every such change & verified to be
operational
4. In case of alarm, the local detection system has interlocks to stop the gas/chemical
flow into a gas/chemical cabinet.
5. Are other interlocks connections from the tool or process chamber/modules
available for connection to an area alarm control panel? ? Yes No

6. If yes, these interlocks are connected to the area alarm control panel.

N R. Radiation Requirements N/A TE/EE EHS

/
A
1. All sources of non-ionizing radiation have been surveyed by SUNY Poly CNSE
Radiation Safety Officer.
2. All sources of ionizing radiation have been surveyed by SUNY Poly CNSE
Radiation Safety Officer.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 17 of 20

 Equipment Commissioning Checklist EHS-00017-F1 R23

S. HPM Delivery System (Liquids and Gases)

IC TE/EE EHS
N/A Process Control Isolation Lock Removal
1. List output delivery lines/sticks that are requested to be turned on.       (fill in line
information)
2. Number of remaining output delivery lines/sticks that will remain locked out for process
control.       (fill in number and type)
3. Identify number and line/stick label for each Tool Installation lock to be removed.
     

     

     

     

7. Identify number and line/stick label for each Chemical/Gas Services process control
lock to be removed.
     

     

     

     

N T. Clean Environments IC TE/ EE EHS

/
A
1. EHS has been provided with location, owner, Hex ID, tool or process, number of units,
size of area covered, quantity and size of prefilter, prefilter type, prefilter material,
commissioning date, and if there is sprinkler protection if two dimensions are >4’ long

N U-1. Lift Station Design A, B, or C IC TE/EE EHS

/
A
1. Unit has been labeled with: tool it supports, primary and secondary owner, contents and
proper GHS symbols and statements.
2. A preventative maintenance plan for testing and service is in place.
3. Lift station was tested.
4. Lift station is fitted with a plumbing vent.
5. There are double check valves on the discharge line.
6. Incompatibles are not being mixed in the lift station.
7. There is secondary containment on the pump discharge.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 18 of 20

 Equipment Commissioning Checklist EHS-00017-F1 R23

N U-2. Lift Station Design B or C EE/TE EHS

/
A
1. Unit has double containment.
2. There is leak detection in the outer containment.
3. There is a Hi-Hi alarm that notifies the system owner, ERT, and AAC or BMS.
4. The capacity of the unit is 110% of the total retention volume of the system.
5. ICW is plumbed to the unit unless it is an incompatible.
6. Local exhaust is connected to the unit.

Notes and Comments

     

Part 2 Interim Sign-offs

This section serves two functions:
1) Allows EHS to provide partial approvals in phases as the tool is prepared for use.
2) Provides System Owners the opportunity to review and approve the parts of the project that they will own.
Phase N/A Signature Print Name Date
1a) EHS: Laser                  
1b) EHS: Other Non-ionizing Radiation
(RF, IR, UV, etc.)                  
1c-) EHS: Ionizing Radiation                  
1d) EHS: HPMs                  
1e) EHS: TGMS                  
2a) System Owner: House Exhaust                  
3a) System Owner: House Drain: AWD                  
3b) System Owner: House Drain: HFD                  
3c) System Owner: House Drain: Solvent                  
3d) System Owner: House Drain: Slurry                  
4a) System Owner: All HPMs                  
5a) Gas and/ or Liquid Delivery and/ or
Waste Collection Systems By Air Liquide                  
6a) System Owner: TGMS testing passed                  

Part 2 Punchlist
List all deficiencies that do not affect the safety of the installation. A Punchlist item may not compromise safety.
Punchlist items as well as Deficient items must be completed prior to Part 2 approval.
Issue Responsibility Completion Date
1.                  
2.                  
3.                  

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 19 of 20

Equipment Commissioning Checklist EHS-00017-F1 R23

4.                  

5.                  
6.                  
7.                  
8.                  
9.                  
10.                 
11.                 
12.                 

Equipment Commissioning Part 2 Approval Signatures

I verify that all Part 1 and Part 2 checklist items (deficient or otherwise) are complete
& I approve this equipment for Part 2 sign-off.
Title Signature Print Name Date
Installation Coordinator (IC)                  
Tool Owner (TO)                  
Tool Engineer / Equipment
Engineer (TE/EE)                  
SUNY Poly CNSE Operations
Manager1                  
SUNY Poly CNSE Equipment
Engineering Manager2                  
SUNY Poly CNSE Environmental
Health & Safety (EHS)                  
SUNY Poly CNSE Facilities Tool
Hook-up Manager                  
SUNY Poly CNSE Code
Compliance Manager                  
SUNY Poly CNSE VP for Facilities
and Infrastructure                  
Notes:
1: Operations Manager cannot sign until MPS has been completed and submitted to Document Control.
2: Equipment Engineering Manager cannot sign until tool tracking spreadsheet has been updated.

Printed copies are considered uncontrolled. Verify revision prior to use.

DCN1241 CNSE Confidential When Completed Page 20 of 20