- Write your Facility Name, Department, and Point of Contact in appropriate areas.
- Product Name: List the name of the product as stated on MSDS.
- Manufacturer Name: Provide the name of the product manufacturer. Many products will have similar names, but are manufactured by different companies and may have different MSDS information.
- Quantity: Provide the total quantity in the blank provided. List the container size and please mark the correct unit of measure.
- State: Provide the physical state of the product [example – solid (S), liquid (L), gas (G), aerosol (AE), or Compressed Gas (*G)]. A powder is considered a solid. If you have a paste, please call it a liquid.
- Hazard Category: Please indicate if the chemical is Flammable (F), Toxic (T), Corrosive (C), Reactive (R), or Unstable (U).
- Storage Location: Provide the room number(s) where the products are stored. Provide the general storage method and conditions (example – CR 349 on metal shelving, room has ventilation).
- Contact Environmental Compliance Manager: Please submit the completed form to the Environmental Compliance Manager to arrange for proper disposal by a licensed company. Do not throw the product away.
Emergency Cell Number 720-340-6579