Document JNaKwB8KVqK29X02bb5y6eEzK
G&orgia GulF
('orporuiion and Af/Uiinas
REQUEST FOR USE Product Name:
ABD00089037
ABERDEEN PLANT CHEMICAL APPROVAL/HAZARD ASSESSMENT FORM
Manufacturer:
Status: New Revision-!^
What will the material be used for?
Pl/c
What department(s) will use this material?
Inventory Requirements: 0 Less than 500 lbs.
Category (check appropriate category) Adhesives & Sealants Catalysts & Initiators Compound - Colorants Compound - Fillers & Lubricants Compound - Other Ingredients Compound - Plasticizers Compound Stabilizers
500-10,000 lbs.
--------------------- ---------------------------------------------U"tjreater than 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
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)
Combustible liquid Compressed gas Explosive
Flammable gas Flammable liquid Flammable solid
Organic peroxide
"Frv/2s:A n *1 . P! Pyrooip`horic ft? ^ ^
Unstable Water-reactive Corrosive
HetfltM-Jazards (check all appropriate)
Carcinogen
Irritant
Biomodes of Entry (check all appr
Eye
T;3T ** *3 *ci
Sensitizer
^g^lnhalation
__________
ngestion
Is training required for this material? (Check one) Comments:
Yes
Approved for use: \
Dace %/SL
Not approved for use:
ENVIRONMENTAL REVIEW
Would this chemical impact plant emissions?
(Check one)
Would this chemical produce hazardous waste?
(Check one)
If hazardous, it is due to: (check all appropriate)
Ignitability
Corrosivity
Reactivity
J&Toxicity
Reportable under SARA 313 under any quantity? (Check one)
55 Yes
Reportable under SARA 311/312?
(Check one)
^ Yes
Is the chemical listed under CERCLA? (Check one)
Yes No
"# Listed as a Hazardous Substance (40 CFR 302.4)
Listed as an Extremely Hazardous Substance (40 CFR 355.20)
j Listed in TSCA Inventory
Is the chemical regulated under DOT (49CFR 172) ? )0Yes Comments:
No
Date:
lyYes 'C Yes
No No
A listed waste No No
RQ:
lbs.
Not approved for use: Entered into DMS by:.
JnppS&t
Date: Date:
Revision Date 5-7-01