[share-ebook]POTENTIALLY EXPLOSIVE CHEMICAL WORKSHEET
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| Preliminary Information |
Record No. ___________ Worksheet Start Date ____________________ Page ___ of _____
EH&S Notified On ____________ Time ____________
EH&S Lead Inspector ________________________________ EH&S Inspection Date _____________________
EH&S Assistant Inspector _____________________________
Lab Contact ________________________________________ Lab Phone ______________________________
Chemical Name ______________________________________________________________________________
Building ___________________________________________ Floor _________ Room _____________
Exact Location In Room ________________________________________________________________________
Eyewash Location ____________________________________________________________________________
Fire Extinguisher Location ______________________________________________________________________
Date Identified by Lab ____________ Identified by ________________________ Phone _______________
Comments _________________________________________________________________________________
Responsible Personnel |
PI/RP __________________________ Department ______________________________
PI/RP Bldg. __________________________ Dept. Chair ______________________________
PI/RP Room __________________________
Department Safety Coordinator (DSC) ______________________________
DSC Phone ___________________________________
Page ____ of ___
| Container and Chemical Information |
Check the label carefully for any signs of information. Sometimes a seemingly useless label can be read and information regarding age or inhibition can be determined.
Container History
Name ______________________________________________________________________________________
Manufactured _________________________ Manufactured date _______________ Lot No. ______________
Type ___________________ Size _______________________ Estimated Amount __________________
Label (Original, Relabeled, or None): _________________________ Date Container Last Opened __________
Date Rec. ___________ Date First Opened ______________ Date Expired ____________ Est. Age ______
Refrigerated? ____________________ Container Opacity _____________ Exposed to heat or light? __________
Chemicals Stored Near? ________________________________________________________________________
Container Condition? __________________________________________________________________________
Other container information _____________________________________________________________________
Literature Search
Appearance and hazards of undegraded, uncontaminated Chemical
Normal Appearance Physical Description
Proper Storage Conditions
Solvent or Inhibitor
Chemical Hazards
Degradation Properties
Appearance and hazards of degraded, or contaminated Chemical
Degraded Appearance – Physical Description
The Chemical may be degrade and become an explosive hazard. Is there evidence of aging, improper storage or use such as:
_________ Peroxide Concentration ________ Inhibitor Depletion _________ Solvent Depletion
_________ Exposure to air causes production of explosive compounds _________ Metals Contamination
Other ______________________________________________________________________________________
Chemical Observations
Page ____ of ____
Peroxide Formers Compounds Other Than Peroxide Formers
| Peroxides Observed? Inhibitor present? Bulging? Rusty? Peroxide Test Result? See “Expert Consultation” before attempting to open. Peroxide Test Date |
Solvent required for stability? Chemical Appearance |
Expert Consultation |
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