CAS number………………………

SECTION 2: Hazards identification

2.1 Classification of the substance or mixture

Delete pictograms that don’t apply! Precautionary Statements: Description of other hazards: Section 3: Composition/ Information on Ingredients For Substances (a) Chemical name (b) Common name and synonyms (c) CAS number and other unique identifiers (d) Impurities and stabilizing additives which are themselves classified and which contribute to the classification of the substance For Mixtures In addition to the information required for substances: (a) The chemical name and concentration (exact percentage) of all ingredients which are classified as health hazards in accordance with WAC 296-901-14008 and (1) are present above their cut-off/concentration limits; or (2) present a health risk below the cut-off/concentration limits. (b) The concentration (exact percentage) must be specified. Chemical Name Synonym CAS# Conc. Section 4: First-Aid Measures (a) Description of necessary measures, subdivided according to the different routes of exposure, i.e., inhalation, skin and eye contact, and ingestion (b) Most important symptoms/effects, acute and delayed (c) Indication of immediate medical attention and special treatment needed, if necessary After skin contact: After eye contact: After inhalation: After swallowing: Section 5: Fire-Fighting Measures (a) Suitable (and unsuitable) extinguishing media (b) Specific hazards arising from the chemical (e.g., nature of any hazardous combustion products) (c) Special protective equipment and precautions for fire-fighters Suitable extinguishing agents: Special protective equipment for firefighters: Section 6: Accidental Release Measures (a) Personal precautions, protective equipment, and emergency procedures (b) Methods and materials for containment and cleaning up Personal precautions: Measures for environmental protection: Measures for cleaning/collecting: Section 7: Handling and Storage (a) Precautions for safe handling (b) Conditions for safe storage, including any incompatibilities Handling: Storage: Section 8: Exposure Controls/Personal Protection (a) DOSH permissible exposure limit (PEL), American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV), and any other exposure limit used or recommended by the chemical manufacturer, importer, or employer preparing the safety data sheet, where available (b) Appropriate engineering controls (c) Individual protection measures, such as personal protective equipment Chemical Name OSHA PEL OSHA PEL ACGIH OEL ACGIH OEL (ceiling) (TWA) (STEL) General protective and hygienic measures: Breathing equipment: Protection of hands: Eye protection: Section 9: Physical and Chemical Properties (a) Appearance (physical state, color, etc.) (b) Odor (c) Odor threshold (d) pH (e) Melting point/freezing point (f) Initial boiling point and boiling range (g) Flash point (h) Evaporation rate (i) Flammability (solid, gas) (j) Upper/lower flammability or explosive limits (k) Vapor pressure (l) Vapor density (m) Relative density (n) Solubility(ies) (o) Partition coefficient: n-octanol/water (p) Auto-ignition temperature (q) Decomposition temperature (r) Viscosity Form: Odor: Odor threshold: pH: Melting point/melting range: Boiling point/boiling range: Flash point: Evaporation rate: Flammability: Upper/lower flammability or explosive limits: Auto ignition temperature: Danger of explosion: Vapor pressure: Vapor density: Relative density: Solubility in/Miscibility with water: Section 10: Stability and Reactivity (a) Reactivity (b) Chemical stability (c) Possibility of hazardous reactions (d) Conditions to avoid (e.g., static discharge, shock, or vibration) (e) Incompatible materials (f) Hazardous decomposition products Reactivity: Chemical stability: Conditions to avoid: Incompatible materials: Hazardous decomposition products: Section 11: Toxicological Information Description of the various toxicological (health) effects and the available data used to identify those effects, including: (a) Information on the likely routes of exposure (inhalation, ingestion, skin and eye contact) (b) Symptoms related to the physical, chemical and toxicological Characteristics (c) Delayed and immediate effects and also chronic effects from short and long-term exposure (d) Numerical measures of toxicity (such as acute toxicity estimates) (e) Whether the hazardous chemical is listed in the National Toxicology Program (NTP) Report on Carcinogens (latest edition) or has been found to be a potential carcinogen in the International Agency for Research on Cancer (IARC) Monographs (latest edition), or by DOSH Acute toxicity: Potential routes of exposure/potential health effects Skin: Eye: Inhalation: Ingestion: Carcinogenic effects: Mutagenic effects: Reproductive toxicity: Sensitization: Target organs: Section 12: Ecological Information (non-mandatory) (a) Ecotoxicity (aquatic and terrestrial, where available) (b) Persistence and degradability (c) Bioaccumulative potential (d) Mobility in soil (e) Other adverse effects (such as hazardous to the ozone layer) Ecotoxicity: Mobility: Biodegradation: Bioaccumulation: Section 13: Disposal Considerations (non-mandatory) Description of waste residues and information on their safe handling and methods of disposal, including the disposal of any contaminated packaging Section 14: Transport Information (non-mandatory) (a) UN number (b) UN proper shipping name (c) Transport hazard class(es) (d) Packing group, if applicable (e) Environmental hazards (e.g., Marine pollutant (Yes/No)); (f) Transport in bulk (according to Annex II of MARPOL 73/78 and the IBC Code) (g) Special precautions which a user needs to be aware of, or needs to comply with, in connection with transport or conveyance either within or outside their premises DOT regulations:  Hazard class:  Land transport ADR/RID (cross-border):  ADR/RID class:  Maritime transport IMDG: Air transport ICAO-TI and IATA-DGR:  ICAO/IATA Class: Section 15: Regulatory Information (non-mandatory) Safety, health and environmental regulations specific for the product in question US Federal Regulations SARA Section 355 (extremely hazardous substances): SARA Section 313 (specific toxic chemical listings): Clean Air Act, Section 112 Hazardous Air Pollutants (HAPs): TSCA (Toxic Substances Control Act): Etc. Section 16: Other Information The date of preparation of the SDS or the last change to it SDS date of preparation/update

Hazard statements

symbol(s) and precautionary statement(s) in accordance with WAC 296-901-14012. (Hazard symbols may be provided as graphical reproductions in black and white or the name of the symbol, e.g., flame, skull and crossbones) (c) Describe any hazards not otherwise classified that have been identified during the classification process (d) Where an ingredient with unknown acute toxicity is used in a mixture at a concentration ≥ 1% and the mixture is not classified based on testing of the mixture as a whole, a statement that X% of the mixture consists of ingredient(s) of unknown acute toxicity is required Hazard Classification

Signal word

Hazard Statements Pictograms Delete pictograms that don’t apply!

Precautionary statements

Description of other hazards