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Hazardous Material Declaration Form: Item(s) To Be Declared: No

A hazardous material declaration form was submitted by a requestor from an unspecified department to declare items to be purchased for a lab located on campus. The form lists hydrogen with a purity of 20% to be purchased locally in a quantity of 9 litres. The requestor and PI must both sign and date the form to declare and acknowledge the hazardous materials.

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CV. Anugerah Bumi Nusantara
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85 views1 page

Hazardous Material Declaration Form: Item(s) To Be Declared: No

A hazardous material declaration form was submitted by a requestor from an unspecified department to declare items to be purchased for a lab located on campus. The form lists hydrogen with a purity of 20% to be purchased locally in a quantity of 9 litres. The requestor and PI must both sign and date the form to declare and acknowledge the hazardous materials.

Uploaded by

CV. Anugerah Bumi Nusantara
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as RTF, PDF, TXT or read online on Scribd
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Print date: 21-Mar-2017

Hazardous Material Declaration Form

Name of PI : ____________________________________ Department : _________________________

Name of Requestor : ______________________________ Lab location : _________________________

Item(s) to be declared:

Overseas or Local
No. Description(s) of Item(s) Chemical Purity (%) Unit of Measure Qty Required Supplier?

1 Hydrogen 20 Litre 9 Local


2
3
4
5
6
7
8
9
10
11
12
13
14
15

Declared by: Acknowledged by:

_______________________________ _______________________________
Requestor's Signature PI's Signature

_______________________________ _______________________________
Date Date

+ Please remember to choose 'Overseas Purchase' if your


chemical to be purchased is outside of Singapore

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