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 ( |
| JSA |
Option to associate a job safety analysis (JSA) Use the ( |
| Additional information |
Description of additional information relevant to the chemical request |
| Attachment |
Any additional documents to be attached for the chemical request. |