OSHA Forms and publications: the OSHA MSDS Form - The Official Material Safety Data Sheet Format

Material Safety Data Sheet	U.S. Department of Labor
May be used to comply with	Occupational Safety and Health Administration
OSHA's Hazard Communication Standard,	(Non-Mandatory Form)
29 CFR 1910.1200. Standard must be	Form Approved
consulted for specific requirements.	OMB No. 1218-0072

IDENTITY (As Used on Label and List)

Note: Blank spaces are not permitted. If any item is not applicable, or no information is available, the space must be marked to indicate that.

Section I

Manufacturer's Name	Emergency Telephone Number
Address (Number, Street, City, State, and ZIP Code)	Telephone Number for Information
	Date Prepared
	Signature of Preparer (optional)

Section II - Hazard Ingredients/Identity Information

Hazardous Components (Specific Chemical Identity; Common Name(s))

OSHA PEL

ACGIH TLV

Other Limits
Recommended

%(optional)

Section III - Physical/Chemical Characteristics

Boiling Point		Specific Gravity (H₂O = 1)
Vapor Pressure (mm Hg.)		Melting Point
Vapor Density (AIR = 1)		Evaporation Rate (Butyl Acetate = 1)
Solubility in Water
Appearance and Odor

Section IV - Fire and Explosion Hazard Data

Flash Point (Method Used)	Flammable Limits	LEL	UEL
Extinguishing Media
Special Fire Fighting Procedures

Unusual Fire and Explosion Hazards

(Reproduce locally)

OSHA 174, Sept. 1985

Section V - Reactivity Data

Stability	Unstable	Conditions to Avoid
	Stable
Incompatibility (Materials to Avoid)
Hazardous Decomposition or Byproducts
Hazardous Polymerization	May Occur	Conditions to Avoid
	Will Not Occur

Section VI - Health Hazard Data

Route(s) of Entry:	Inhalation?	Skin?	Ingestion?
Health Hazards (Acute and Chronic)


Carcinogenicity:	NTP?	IARC Monographs?	OSHA Regulated?

Signs and Symptoms of Exposure

Medical Conditions Generally Aggravated by Exposure

Emergency and First Aid Procedures

Section VII - Precautions for Safe Handling and Use

Steps to Be Taken in Case Material is Released or Spilled

Waste Disposal Method

Precautions to Be taken in Handling and Storing

Other Precautions

Section VIII - Control Measures

Respiratory Proctection (Specify Type)
Ventilation	Local Exhaust	Special
	Mechanical (General)	Other

Protective Gloves	Eye Protection
Other Protective Clothing or Equipment
Work/Hygienic Practices

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* U.S.G.P.O.: 1986 - 491 - 529/45775