ࡱ> \_[ *:bjbj 0H P>ddGGG[[[8t,[53;;;;VChI5K5K5K5K5K5K57:K5iG"K5;;5###R8;8;I5#I5##2/)4;Гv[>)355505=3@;,@;()4)4@;G=4w>,#$wwwK5K5 www5@;wwwwwwwwwd m: San Jose State University Institutional Animal Care and Use Committee Abbreviated Protocol for the Care and Use of Fertile Eggs or Invertebrate Species Type and return the signed original form with an introductory cover letter and any necessary permits to the Animal Care office @ campus zip 0100. Protocol for Care & Use of Vertebrate Fertile Eggs  FORMCHECKBOX  Protocol for Care & Use of Invertebrates  FORMCHECKBOX  1. Principal Investigator:  FORMTEXT       Department:  FORMTEXT       Co-Investigator:  FORMTEXT       phone:  FORMTEXT       email:  FORMTEXT       Project Title:  FORMTEXT       Classroom/Instructional  FORMCHECKBOX  Research Project  FORMCHECKBOX  Field Study  FORMCHECKBOX  Animal Housing/Exhibition  FORMCHECKBOX  2. Genus, Species and Common name:  FORMTEXT       (attach list if multiple species) Source of live animals:  FORMTEXT       Overall number of animals to be used:  FORMTEXT       For Care or Use of Invertebrates Species, check all that pertain to IACUC policy requirements:  FORMCHECKBOX  Holding of cephalopods for >12 hours.  FORMCHECKBOX  Species are listed as endangered, threatened, or of special concern at Federal or local levels.  FORMCHECKBOX  Species are considered poisonous, venomous, or a threat to human or public health.  FORMCHECKBOX  Non-native species that requires permission from the State or local authority to possess or handle. For Vertebrate Eggs, what term in gestation will embryos be acquired and terminated?  FORMTEXT      to  FORMTEXT      days 3. Briefly describe the project purpose (150 words or less):  FORMTEXT       If housing animals, identify the facility and room location and describe husbandry equipment, procedures and schedule:  FORMTEXT       List all personnel working with animals: (include their affiliation, role in the project, relevant experience and required training in animal care and use):  FORMTEXT       Describe all procedures and manipulations involviGIJV_gs   $ . / 0 2 ? F M X d f g u v w } tjhphIqi5aJjh\h\UaJjh\UaJ h\aJ h 5aJhph\5aJ h aJhph\aJhyh.xh\h2 h25 hpCJ h!CJ h2CJhphpCJaJ h2CJ h2CJ$jh2UmHnHu)GHIJ/ 0 T  V ydgd8 hdh^hgd&` dh]gddhgd!$dX]`a$gd $a$gd\gd.x$a$&$d%d&d'dNOPQgdp$a$ $&dPa$  ( , . 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Will hazardous substances or materials be used in this study?  FORMCHECKBOX  No  FORMCHECKBOX  Yes (attach SDS) If yes, explain (including use of any personal protective equipment to be used):  FORMTEXT       How will the specimens be disposed of:  FORMCHECKBOX  In red bags placed in carcass freezer; DH-437; or Other, explain:  FORMTEXT       5. Requested IACUC Approval Period (3-year max):  FORMTEXT       to  FORMTEXT       6. I certify that all the above information is complete and accurate, and hereby assure the IACUC that any modifications hereto will be submitted for approval before any change is instituted. Signature of Principal Investigator:______________________________ Date:  FORMTEXT       SJSU IACUC Approval: _________________________ __________________________ _____________________ Chairperson Signature Date Personnel Health RC Level _____________________ version 2015     #_____________ IACUC USE ONLY 81:1<1N1P1l1n1p111@2B2F2H2\2^2`2j2l2z222222223׽׷׷}oeQoGhkCJOJQJ'j h?|ghq?YCJOJQJUhq?YCJOJQJjhq?YCJOJQJU hq?YCJhq?YjhlbCJUmHnHujL hy_XhlbCJUjhlbCJU hsMCJ hlbCJj h!hkCJUjhkCJU hkCJjhkCJOJQJU'jd h!hkCJOJQJU333R3Z3333333333333444,4.404:4<4H4J4^4`4b4l4n4p4r4t4B5H5仴wlwea]h\h2 h25\j"hQNU-jhQNOJPJQJU^JmHnHo(uj hQNUjhQNU hQN5\hQNhq?Yh?|g h?|g5\hq?Yh?|gCJjhq?YCJUmHnHuj6 h?|ghq?YCJUjhq?YCJU hkCJ hyCJ hq?YCJ$H5f5t55555j6v666666666666667 88828B8r8t8v8x888窤}smg`Y hr>*CJ hy>*CJ h4f.CJ hyCJhyh4f.>*CJh4f.5CJ\ *h?|gh4f.5CJ\ *h4f.5CJ\ h4f.>*CJ hC3CJ h2CJh25CJ\h85CJ\jh?|gUmHnHujh2Ujh?|gUh?|g h2CJ hD hD hD h8h2!555667 888t8v8x88889 999999 d]gdrgd4f.dh & F h0dX`0gd* h2CJh2h?jh?Uh4f.h4f.CJaJh4f.CJaJ hC3>*CJ hr>*CJ hy>*CJ hC3>*CJ99 999999 :":$:&:(:*: .:p.+/ =!"#$% tDeCheck7tDCheck8tDText1tDText2tDText3tDText4tDText5vDText22tDeCheck1tDeCheck2tDeCheck3tDeCheck4tDText6vDText10vDText11tDeCheck1tDeCheck2tDeCheck3tDeCheck4vDText16vDText15vDText10vDText10vDText10tDText9tDeCheck1tDeCheck2vDText17tDeCheck5vDText20vDText18vDText19vDText21^ 2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~_HmH nH sH tH 8`8 Normal_HmH sH tH >@>  Heading 1$dh@&CJF@F  Heading 2$hd@&^hCJF@F  Heading 3$hd@&`hCJDA`D Default Paragraph FontViV  Table Normal :V 44 la (k (No List 0>@0 Title$a$58B@8 Body Text$a$CJ4@4 Header  !4 "4 Footer  !H2H 3\`?/[G\!-Rk.sԻ..a濭?PK!֧6 _rels/.relsj0 }Q%v/C/}(h"O = C?hv=Ʌ%[xp{۵_Pѣ<1H0ORBdJE4b$q_6LR7`0̞O,En7Lib/SeеPK!kytheme/theme/themeManager.xml M @}w7c(EbˮCAǠҟ7՛K Y, e.|,H,lxɴIsQ}#Ր ֵ+!,^$j=GW)E+& 8PK!Ptheme/theme/theme1.xmlYOo6w toc'vuر-MniP@I}úama[إ4:lЯGRX^6؊>$ !)O^rC$y@/yH*񄴽)޵߻UDb`}"qۋJחX^)I`nEp)liV[]1M<OP6r=zgbIguSebORD۫qu gZo~ٺlAplxpT0+[}`jzAV2Fi@qv֬5\|ʜ̭NleXdsjcs7f W+Ն7`g ȘJj|h(KD- dXiJ؇(x$( :;˹! 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