Chemical Inventory For Small Quantities At Single Locations
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1
2
32001 RIGHT TO KNOW SURVEY UPDATE
SMALL
CHEMICAL INVENTORY FOR
QUANTITIES AT SINGLE LOCATIONS
(PHOTOCOPY THIS SHEET IF YOU NEED ADDITIONAL FORMS)
NJEIN : 99999912007
ENTER CODES
SIC: 8221
(See Page 2 of Survey for Codes)
EMPLOYER NAME: Rutgers University
FACILITY NAME: Douglass Student Center
1.
2. HAZARDOUS CHEMICAL NAME
3.
4.
5.
6.
7.
8.
9.
10.
11.
SUBSTANCE
CAS
DOT
C
M
I
U
NUMBER OF
SPECIAL
EXACT
NUMBER
O
I
N
N
EMPLOYEES
HEALTH
LOCATION
N
N
N
X
V
I
EXPOSED OR
HAZARD
OF
U
U
T
T
E
T
POTENTIALLY
CODES
PRODUCT
M
M
A
U
N
EXPOSED
ON SITE
B
B
I
R
T
(Optional)
E
E
N
E
O
R
R
E
R
R
Y
PRODUCT NAME: Maxi Clean
BP
11
P
12
0835
Ethanolamine
141-43-5
2491
54
CA
0876
Ethylenediamine tetraacetic acid
64-02-8
9117
52
PRODUCT NAME: Lime-A-Way
BP
11
G
12
1516
Phosphoric acid
7664-38-2
1805
54
CO
PRODUCT NAME: Glass Class
BP
10
G
12
1076
propanol
67-63-0
1219
52
F3
0275
butoxyethanol
111-76-2
2369
52
PRODUCT NAME: Greasecuter
BP
10
G
12
1706
Sodium hydroxide
1310-73-2
1823
52
CO
0275
butoxyethanol
111-76-2
2369
52
0835
ethanolamine
141-43-5
2491
52
CA
Page _1_ of __4_
Approval number 99-10165
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