Chemical request form
Field and description for a chemical request form. The chemical request form is used by an employee to request for an existing or a new chemical.
| Field | Description |
|---|---|
| Select Chemicals | Lists the names of existing chemicals |
| New Chemical check box | Option to request a chemical that is not in the existing list |
| New Chemical | Name of the chemical that is not in the existing list Note: This field appears when New chemical check box is selected |
| Upload | Button to upload a Safety Data Sheet \(SDS\), if available |
| Approvals due | Date on which approval is needed |
| Location | Name of the location the chemical will be used in |
| Cost Center | Department in your organization that pays for the chemical request |
| Usage Details | |
| Describe how the chemical will be used | Description on the use of the chemical |
| Purpose | Options to select the purpose of the chemical request |
| Container Type | Type of container holding the chemical |
| Frequency of Use | Determines how often a chemical will be used. |
| General period of use | Period when the chemical will be in use |
| Start date of use | Specific start date for the use of chemical |
| End date of use | Specific end date for the use of chemical |
| Volume details | |
| Physical state | Physical state of the chemical For example, If the chemical is Gasoline, the physical state is Liquid. |
| Overall Expected consumption | Value and unit of chemical consumption |
| Overall Quantity | Total quantity required by the organization |
| Quantity unit of measure | Unit of measure for the quantity |
| Additional Details | |
| Risk assessment | Option to associate a risk assessment Use the \( Image omitted: circle-info-outline-24.svg info icon\) icon to preview the risk assessment record |
| JSA | Option to associate a job safety analysis \(JSA\) Use the \( Image omitted: circle-info-outline-24.svg info icon\) icon to preview the JSA record |
| Additional information | Description of additional information relevant to the chemical request |
| Attachment | Any additional documents to be attached for the chemical request. |
Parent Topic:Health and Safety Environmental Management reference