Chemical Inventory Form Page 3

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Joel Klein
Chancell
PRINT OR TYPE ALL INFORMATION
Page ______ of ______
School/Division
Name of person completing form
Address
Title
Department
Room
Work Phone
Date
1 Product Trade Name
2 Manufacturer’s Name &
3 Exact Storage
4 Warnings on Label
5 Other Identifying
6
7
8
9
10
11
12
Address
Location
Information
CAS #
CAS #
CAS #
CAS #
CAS #
CAS #
Physical State – Item 6
Container Type – Item 8
Units of Measure – Item 9
Frequency of Use – Item 11
S – Solid or Powder
A – Above ground tank
F – Can
M – Glass bottles or Jugs
C – Cubic feet for gas
S – Sometimes
L – Liquid
B – Below ground tank
I – Fiber drum
N – Plastic bottles or Jugs
lb – Pounds for solids
O – Often
G – Gas
C – Tank inside building
J – Bag
O – Tote Bin
oz – Ounces for solids
N - Never
P – Pure
D – Steel drum
K – Box
R - Other
G – Gallons for liquid
M - Mixture
E – Plastic or non-metallic
L – Cylinder
fl – Fluid ounces for liquid
drum
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