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INFORMATION SECTION UJ - M Kift-V 111
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Phone No.
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Please assign number(s) to the sample(s) described on the attached "Sanqple Submitted For Toxicity Evaluation" form(s).
The Medical Research Project Number (MR) assigned to this study is / yio_____
The sample(s) will be studied to determine -r/e-cc-g- me t a l s *
[Type(s) of Toxicity Test(s)]
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Haskell Number.
HASKELL LABORATORY FOR TOXICOLOGY AND INDUSTRIAL MEDICINE
SAMPLE SUBMITTED FOB TOXICITY EVALUATION
Department. ORC'-16 H
.Division.
.Location,
Systematic Name of Chemical:
*re.Aco
a a e Ta l -s flrsjAi-VS'S
L& h *
Synonym, Product Name and/or Designations:
/J*.r-r-ir\
fi /(jo,
O. e-ft- ' u O- /. 1
V 5"
/^S./--<5-
A7 f" 0J"> fC. <C\ *-v a. r~ t
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g /-Jy6o
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Sample: Code No.
.Lot No..
.Amount.
y
Grade___
.Color__
.Form.
.Mol. Wt,
Special Handling Requirements___ ___. ---
......... .
Is it explosive in air?in oxygen?,.........if so, at what concentrations?
Active Ingredient
____
%
Composition, if a mixture (are percentages by weight or volume?)
Impurities (Identity and amounts; are percentages by weight or volume?)
Properties: mp .
rp
# 25C. --------- ---
vp
Max. Process Twn.
Sp.Gr.------ pH
Vapor- Density (air i ^
Flash Point (Open onp^
(rAnamA mipl
Solubility (Quantitative, if possible) in
Ethanol_______________ Vegetable oil
Solvents
Proposed Use:
(Attach VP curve if
Present Stage of Development: Research / .Semiworks.
.Mfg..
.Sales. (OVER)
1045^40002135
N25903.01
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*7 5 S9Haskell Number
HASKELL LABORATORY FOR TOXICOLOGY AND INDUSTRIAL MEDICINE
SAMPLE SUBMITTED FOR TOXICITY EVALUATION
Department. Oec-MEV-I
MvliHnn
Systematic Name of Chemical: l=i-SW
Te.fl.ce
MetfllS Ak iALV-3 >s
Synonym, Product Name and/or Designations:
^3rOtc>Ki
^ "7
` j+'t-- * ppc--^
S l^
Formula:
A i ^ ' f'e.
H 3-/
Sample:
A'Hev-.'V ` ^
SvT^^t n bid* Or*rf-b
Code Wq . ..
r,r>t Na .
3 1
- -...
A v-*c . b o u y
A Vyi dr ' c.Ct'-- *3 et*---l
l C-tn a Uc-J"
lowj r=V''Tf<-^b VV* * v-< o Kj
T3lu-<.
Wh c .it -y--
.Amount.
IT'S
H 1 I \
<3
fe,7 /P-`S A ;
/
& /t/tt <Sj ! //'Su^Rsh J
Grade.-
.Colpr.
.Form.
.Mol, Wt..
Special Handling Requirements__ .
Is it explosive in air?_____in oxygen?.
Active Ingredient ,, , ,
. ,, .
.if so, at what concentrations?.
%_________
Composition, if a mixture (are percentages by weight or volume?)
Impurities (Identity and amounts; are percentages by weight or volume?)
Properties: MP_
. BP...
% 25C. .VP
% Max. Process Temp.
(Attach VP curve if
-available)
Sp.Gr.
-pH.
.Vapor Density (air 1).
Flash Point (Open cup).
.(Closed cup).
Solubility (Quantitative, if possible) in
Ar-t-.rm
Ethanol______________ Vegetable oil
n.hf Solvents.
Proposed Use:
Present Stage of Development: Research. s/ .Semiworks.
.Mfg..
_Sales. (OVER)
104:fPiip49?02136
N25903.02
S/\A,y "SAMPLES
1 SLOHaskell Number
HASKELL LABORATORY FOR TOXICOLOGY AND INDUSTRIAL MEDICINE
nepartTwewt
SAMPLE SUBMITTED FOR TOXICITY EVALUATION
O ^ K-j (z j\/i
^-
THv^e-tnn
T.nret^ nn
Systematic Name of Chemical:
MeTHS
A+sAO'S**
Synonym, Product Name and/or Designations:
Kj. 1 low FVt. 1' 1 Kl-i. r- CJ IA/^\ y> yi OtAi
! Z-
Formula:
St-^Wn >u,H
oUji '
FSa-r-c^L.
f3c y Av'&.kxwy
1
is s' /
Sample: Code No.______ Lot No.
Ho^ 0^1" *S+ r
loss's
Amount
Pn1rtT
ffnfm
Mr.1 . Wt.
V )
Special Handling Requirements ______
:. . -.
Is it explosive in air?in oxygen?_____if so, at what concentrations?
Active Ingredient. , .. ......
....%
Composition, if a mixture (are percentages hy weight or volume?)
Impurities (Identity and amounts; are percentages hy weight or volume?)
6 25C ________ Properties: mp b p v p
S Max. Process Temp.
Ap r.-r
pH - --Vapor Density ( air ? ^
Flash Point (Open enpV
fm neart eup^
Solubility (Quantitative, if possible) in water
Anetnne
PtVmnnl
Vegetable Ml
Dfher Solventa
Proposed Use:
(Attach VP curve if
yPresent Stage of Development: Research.
.Semiworks.
.Mfg..
.Sales. (OVER)
iJ_QiDUP04q002137
N25903.03