Cannabis Research Permit Application

Directions:

Submit the completed form via email to cannares@uoguelph.ca

In the event of insufficient space, please attach additional pages labelled with the applicable section number.

General Information

Does this application replace an existing Guelph Cannabis Research Permit?

No	Yes. Please provide previous permit number: Click to enter permit #

Proposed start date: Click to enter a date Expected completion date: Click to enter a date

Principal Investigator

Principal Investigator	Department	Phone	E-mail
Click to enter PI name	Click to enter department name	Click to enter phone	Click to enter email address

Research Summary

Title(s):
Click to enter title(s) of research

Research type:

Select all that apply

Analysis/assessment	Growing conditions	Horticultural practices

Research with human participants. If yes provide REB approval number: Click to add REB #

Human clinical trials. If yes, include No Objection Letter issued by Health Canada.

Research with human participants is not considered clinical trials e.g. assessment of taste, sight, smell or touch

In-vitro

In-vivo (animal research). If yes provide AUP number: Click to add AUP # and indicate type of animal research below:

Animal research is a veterinary clinical trial. If yes, include Experimental Study Certificate issued by Health Canada

Animal research is not a veterinary clinical trial.

Plant genetics	Plant breeding	Processing practices

Pest control

This project involves cultivation, growth and/or propagation

This project involves synthesis of cannabinoids

This project involves production of cannabis products

This project involves teaching activities

Other. Please describe:

Using plain language, please provide an overview of the research program.

Objectives/Intent:
Click to enter the objectives and/or intent of the research

Description of Project including Methodology If growth, propagation or cultivation is involved, include a description of odour control strategies.
Click to enter a description of the project including a description of the methodology

Personnel

Designate

The Designate must be a faculty member, professional staff member or a senior technician. Graduate students may not be named as Designates.

Designate(s) in absence of PI	Department	Phone	E-mail	Access required?
Click to enter designate name	Click to enter department name	Click to enter phone	Click to enter email	Choose an item

Investigative Personnel

I confirm that all personnel involved in the work described in this application are at least 19 years old.

I confirm that I and all personnel involved in this work have completed the Cannabis Research Program training module on Courselink and that new personnel will only be permitted to begin work upon completion of this training.

Other Approvals

This project involves the use of radioisotopes:	No Yes. If yes, provide permit #: permit #

This project involves the use of biohazards (microorganisms): No Yes. If yes, provide permit #: permit #

Cannabis Materials

Select one of the following:

This project involves the use of approved cultivars of industrial hemp only (i.e. THC concentration 0.3% or less THC in leaves or flowering heads)

This project involves the use of cultivars of industrial hemp only. Cultivars are not approved.

This project involves the use of cannabis that is not classified as industrial hemp.

6.1 Source

Sources of cannabis must be from a legal source.

The cannabis will be obtained from a licensed source in Canada (e.g. licensed retailer, license cultivator, license processor).

The cannabis will be imported under a Health Canada import permit as well as CFIA import permit if required.

Cannabis Material	Maximum Quantity at any one time	Units	Equivalent dry weight cannabis	Description
THC	THC	g	Eq dry weight	description
CBD	CBD	g	Eq dry weight	description
Plants (for growth/cultivation, including tissue culture)	plants	growth area in m2	Eq dry weight	description
Fresh plant material (for processing, analysis, assessment, etc. not already accounted for above)	fresh plant material	g	Eq dry weight	description
Dried cannabis	dried cannabis	g	Eq dry weight	description
Oils/extracts/concentrates (>3% THC by weight)	concentrates	g or ml	Eq dry weight	description
Edibles. Describe including concentration or amount of THC	edibles	g	Eq dry weight	description
Seeds	seeds	Number of seeds	Eq dry weight	description
Other phytocannabinoids not listed above	other	g	Eq dry weight.	description

Refer to the University’s Cannabis Security Matrix for equivalent amounts.

Location

7.1 Campus sites

Please provide information regarding all work locations that will be required for this project. Note that only buildings included in the University’s license are included in the dropdown menu. Buildings are named as per the Physical Resources list of buildings and are listed in order of their building number.

Building name	Room Number	Purpose/Type (e.g. lab, growth, storage, animal holding, other)	Cannabis Research Security Level (determined by the quantities and activities outlined above)
Choose the building	Add room #	Select the primary purpose of the location	Choose the research security level
Choose the building	Add room #	Select the primary purpose of the location	Choose the research security level
Choose the building	Add room #	Select the primary purpose of the location	Choose the research security level

7.1.1 Security Measures

Please refer to the University of Guelph’s Cannabis Security Matrix for security expectations.

Security measures that will be taken to prevent unauthorized access (check all that apply):

Location	Physical Security measures
Laboratory Applicable Not applicable	Lab remains locked when not occupied	Access restricted. Access by key.	Access restricted. E-access (key card or fob access). Access records maintained	Unsupervised access restricted to only those involved in the project	Room monitored for intrusion via audible alarm	Intrusion detection alarm monitored remotely via Campus Police	Monitored via video surveillance
Laboratory continued	Intrusion detection system includes door sensors	Intrusion detection system includes motion detection	Other Describe: Click to any describe other physical security measures in the lab	Comments if applicable: Click to add comments including clarification if identified security measures do not apply to all lab locations
Greenhouse Applicable Not applicable	Greenhouse remains locked when not occupied	Access restricted. Access by key.	Access restricted. E-access (key card or fob access). Access records maintained	Unsupervised access restricted to only those involved in the project	Greenhouse monitored for intrusion via audible alarm	Intrusion detection alarm monitored remotely via Campus Police	Monitored via video surveillance
Greenhouse continued	Intrusion detection system includes door sensors	Intrusion detection system includes motion detection	Other Describe:Click to any describe other physical security measures in the greenhouse	Comments if applicable: Click to add comments including clarification if identified security measures do not apply to all greenhouse locations
Growth chamber Applicable Not applicable	Growth chamber remains locked when not occupied	Access restricted. Access by key.	Access restricted. E-access (key card or fob access). Access records maintained	Unsupervised access restricted to only those involved in the project	Growth chamber monitored for intrusion via audible alarm	Alarm monitored remotely via Campus Police	Monitored via video surveillance
Storage	Lock box	Locked cabinet, refrigerator or freezer	Safe	Cabinet, refrigerator, freezer or safe secured to the wall or floor	Dedicated locked storage room	Monitored for intrusion via audible alarm	Intrusion detection alarm monitored remotely via Campus Police
Storage continued	Monitored via video surveillance	Intrusion detection system includes motion detection	Access to storage location restricted to only those involved in the project	Access to storage location restricted to PI and designate	Records of access to storage location maintained	Other. Describe: Click to any describe other physical security measures in the storage location
Secondary locations Applicable Not applicable	Material will remain in the care and control of an individual directly involved in the project	Other Describe:Click to add other physical security measures in secondary locations
Other security measures	Additional /alternate physical measures used (if any). Describe:Click to add any additional or alternate physical security measures used.

7.2 Transfer

Please provide information regarding any anticipated transfers of materials to individuals not listed on the application. With very limited exceptions, all cannabis materials must be destroyed at the end of the project. Note that all transfers must be appropriately documented within the inventory and approved in advance.

Name of the Institute or organization	Name of contact	Purpose	Health Canada License # or University of Guelph Cannabis Research permit #
Name of institution	Name of contact	Purpose	License or permit number
Name of institution	Name of contact	Purpose	License or permit number

Destruction and Waste Management

I confirm that the SOP for destruction of cannabis wastes will be included with the submission of this application.

8.1 Waste Management

Cannabis materials are to be destroyed prior to disposal using a method approved by Health Canada as part of the University’s Cannabis Research License. For each type of material, specify means of destruction to be used.

Type of Material	Autoclaved and mixed with soil and/or culture materials	Ground and mixed with at least equal parts other materials	Mixed with liquid soap and solid absorbent	Not applicable
Plant Material	Not applicable
Seeds	Not applicable
Oil/extracts/concentrates	Not applicable	Not applicable
Cannabinoids	Not applicable	Not applicable
Other, specify:

Inventory Recordkeeping

Strict ongoing inventories of cannabis materials must be maintained to ensure compliance with the University’s Cannabis Research License. These must be available for inspection upon request.

I confirm that I have read and understand the University’s Cannabis Research Program Guideline OR-RR-G-009. I understand my responsibility to ensure that all inventory maintenance procedures are adhered to within this project.

Record Type	Location of record	Form (electronic or hardcopy)
Receipt	Click to add location of record	Choose the form
Usage	Click to add location of record	Choose the form
Transfer	Click to add location of record	Choose the form
Destruction/disposal	Click to add location of record	Choose the form
Access to storage	Click to add location of record	Choose the form
Other: Click to add other record type	Click to add location of record	Choose the form

Principal Investigator’s Certification

I certify that the information provided in this application form is accurate and that any changes will be submitted for approval prior to initiation.

I agree to follow all University Cannabis Research program and procedures as applicable to my project.

I accept responsibility for training of all research, facility and support personnel involved in work described in this application.

I accept responsibility for safeguarding the cannabis from loss, theft or unauthorized access.

___________________________________________________	________________________________

Signature, Principal Investigator	Date

___________________________________________________	________________________________

Signature, Chair/Director	Date

Approval

___________________________________________________	_________________________________

Signature, Manager Research Risk	Date

Signature, Chair – Cannabis Research Committee	Date

(required for Security Level 3 only)

APPROVAL NUMBER: For Administrative Use Only

EXPIRY DATE: For Administrative Use Only

APPROVAL CONDITIONS: For Administrative Use Only

Supplemental information will be required.

Secondary locations include those where samples will be taken for assessment by specialized equipment

Cannabis otherwise consumed in animal or human participant research does not require further destruction.