Document 5kjeDyRp9NQmyGYnDQLzV3bN4
Georgia Gulf
Corporation and XJfiHatc*
REQUEST FOR USE Product Name:
ABDOOO17679
ABERDEEN PLANT CHEMICAL APPROVAL/HAZARD ASSESSMENT FORM
Manufacturer:
Status: New Revision
What will the material be used for?
What department(s) will use this material?
Inventory Requirements: Q Less than 500 lbs.
Category (check appropriate category) Adhesives & Sealants Catalysts & Initiators Compound - Colorants I'l Compound - Fillers & Lubricants Compound - Other Ingredients Compound - Plasticizers Compound Stabilizers
Q 500-10,000 lbs.
Fuels - Gases or Liquids Heat Transfer Fluids Industrial Gases - Pipeline or Cylinder Laboratory Reagents or Chemicals Landscaping/Pest Control Lubricants Miscellaneous - Not Otherwise Listed
[] Greater than 10,000 lbs.
Paintings & Coatings Process Chemicals & Additives Raw Materials Refrigerants Solvents & Cleaners Water Treatment Chemicals Filter Media/Aids or Absorbents
Requested by:
Date:
Note: PLEASE ATTACH THE MSDS TO THIS FORM AND FORWARD BOTH TO THE IH/SAFETY COORDINATOR
SAFETY REVIEW (29 CFR 1910.1200)
Physical Hazards (check all appropriate)
G Combustible liquid
Flammable gas
Organic peroxide
Unstable
Compressed gas
Flammable liquid
Oxidizer
Water-reactive
Explosive
Flammable solid
G Pyrophoric
Corrosive
^Health Hazards (check all appropriate)
* Carcinogen
G Irritant
Biomodes of Entry (check all appropriate)
Eye
Skin
Is training required for this material? (Check one)
Comments:
Sensitizer
Inhalation
Yes
I! No
Toxic Ingestion
Approved for use:
Date
Not approved for use:
ENVIRONMENTAL REVIEW
Would this chemical impact plant emissions?
(Check one)
Would this chemical produce hazardous waste? If hazardous, it is due to: (check all appropriate)
(Check one)
Ignitability
Corrosivity
G Reactivity
Toxicity
Reportable under SARA 313 under any quantity? (Check one)
Yes
Reportable under SARA 311/312?
(Check one)
Yes
Is the chemical listed under CERCLA? (Check one)
Yes
III No
G Listed as a Hazardous Substance (40 CFR 302.4)
G Listed as an Extremely Hazardous Substance (40 CFR 355.20)
G Listed in TSCA Inventory
Is the chemical regulated under DOT (49CFR 172) ? GYes
DNo
^Comments:
Date:
Yes Yes
No No
A listed waste No No
RQ:
.
lbs.
Approved for use:
Not approved for use: Entered into DMS bv:
Date:
Date: Date:
Revision Date 5-7-01