REVISION DATE:________________  PREPARER:__________________________________  TELEPHONE NUMBER:__________________ SHEET:_____ OF______
                                                                                                        (print name)
DEPARTMENT:______________________________________________________   BLDG #:_________    ROOM # OR AREA:___________________________________

UNIVERSITY OF NEW MEXICO
DEPARTMENT OF SAFETY AND RISK SERVICES
CHEMICAL INVENTORY FORM INSTRUCTIONS

Call 277-2753 if you have questions

1.         DEPARTMENT:  The department to which the Principal Investigator reports, or is a part of.

2.         BLDG #:  The building number commonly associated with this structure by PPD or OCP.

3.         ROOM # OR AREA:  The room # or a well known descriptor for the area.

4.         NAME OF CHEMICAL OR PRODUCT:  Exact name as it appears on the label and on the Material             Safety Data Sheet (MSDS).  If a mixture is being inventoried that was not purchased as such, list each             chemical or product name in the mixture and the concentration of each chemical or product in the             mixture.

5.         NAME OF MANUFACTURER OR DISTRIBUTOR:  Exact name of manufacturer or distributor as             it appears on the label and on the Material Safety Data Sheet (MSDS).  If a mixture is being inventoried that was not purchased as such, list the manufacturer or distributor of each component chemical or      product.

6.         CHEMICAL ABSTRACT SERVICES (CAS) NUMBER:   If not a mixture, enter the CAS number provided on the MSDS.

7.         ORIGINAL CONTAINER?:  Is the chemical or product present only in it’s original container as             supplied by the manufacturer or distributor?  (i.e.  is it transferred to a different container?)

8.         CONTAINER SIZE:  Size of the container as listed on the label or as estimated (i.e. 5g, 1lb, 10ml, 4L, 5kg, 55gal, etc.).  If material is contained in cylinders or other containers, quantify type and size.

9.         MSDS PRESENT?:  Is a manufacturer’s or distributor’s Material Safety Data Sheet (MSDS) available and readily accessible to all employees that may be potentially exposed to this product?  If any are missing a MSDS, contact the manufacturer or your supplier, and request one.  OSHA requires manufacturers to send MSDS’s within 30 days of a written or telephoned request.  Most manufacturers have web sites, which allow customers to retrieve or print a MSDS.