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    Appendix A APNC - Asphalt

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    shiela fernando
    This form is used to request approval for purchasing a new chemical and must be filled out with details of the chemical such as its name, formula, and SDS before it can be used on site. It requires sign off from the warehouse, health and safety team leaders, and industrial hygiene and environment sections before the chemical is approved. The form collects information on the proposed chemical, its use, risk controls, and who will handle it to help evaluate the chemical for approval.

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    Appendix A APNC - Asphalt

    Uploaded by

    shiela fernando
    17 views1 page
    This form is used to request approval for purchasing a new chemical and must be filled out with details of the chemical such as its name, formula, and SDS before it can be used on site. It requires sign off from the warehouse, health and safety team leaders, and industrial hygiene and environment sections before the chemical is approved. The form collects information on the proposed chemical, its use, risk controls, and who will handle it to help evaluate the chemical for approval.

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    Appendix a APNC - Asphalt

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    This form is used to request approval for purchasing a new chemical and must be filled out with details of the chemical such as its name, formula, and SDS before it can be used on site. It requires sign off from the warehouse, health and safety team leaders, and industrial hygiene and environment sections before the chemical is approved. The form collects information on the proposed chemical, its use, risk controls, and who will handle it to help evaluate the chemical for approval.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    17 views1 page

    Appendix A APNC - Asphalt

    Uploaded by

    shiela fernando
    This form is used to request approval for purchasing a new chemical and must be filled out with details of the chemical such as its name, formula, and SDS before it can be used on site. It requires sign off from the warehouse, health and safety team leaders, and industrial hygiene and environment sections before the chemical is approved. The form collects information on the proposed chemical, its use, risk controls, and who will handle it to help evaluate the chemical for approval.

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    Appendix-A: Approval for Purchase of New Chemical (APNC) Form

    It is a mandatory requirement that all hazardous substances/materials supplied for use at work must be accompanied by a
    current Safety Data Sheet which has been approved by Health & Environment. In case of a new chemical, this form shall be
    filled, communicated to Team Leader, Warehouse and shall be sent to Team Leader, Health & Environment along with the
    manufacturer supplied SDS for review and approval. The format of SDS required to be submitted is provided in Appendix-B.

    Correct Technical Name & CAS / EINECS Number Asphalt CAS: 8052-42-4; Hydrogen Sulfide CAS: 7783-06-
    4

    Chemical Formula / Generic Chemical Group Refer Attached SDS


    (Asphalt)
    Area / Unit (where proposed to be used) Units 02/11 - (Road and Ditch Repair Works)

    Does it replace any existing chemical? If so, give name of existing chemical No
    proposed to be replaced and reason for replacement.
    Is it more or less hazardous than the existing chemical? Refer to Definitions
    & Health Hazard Determination (sections 4 & 6 of
    KIPIC/HSESF/SYSOH/18/1602 Chemical Hazard Management) * Note 1

    What is the method of use? For example, refilling will be done from drums / Refilling will be done from Asphalt Truck
    cans by hand or pump etc and how many times in a shift?

    Approximate anticipated use (amount/frequency) per shift? 15 m3


    Quantity that will be kept at chemical shelter at any given time?
    Container Type/Size: Asphalt Truck

    Any alternate chemical available which is less hazardous? None Known

    What risk control measures are proposed to be implemented? (Engineering User Instructions, PPE, Warning signs, Eye Wash
    Controls, Training, Warning signs, user instructions, PPE, Emergency Station, Spill kits, Hazardous waste container
    response & Waste disposal measures etc)
    Stored and used at temperatures ranging between 130°C to 200°C and
    Compatibility with other chemicals in the Area (synergy, storage, reactivity, never exceed the industry recommended maximum safe working
    etc.): temperature of 200°C. Asphalt should not be overheated during handling
    and storage. Clean, dry and heat resistant hoses should be used. Keep
    away from any oxidizing materials due to its incompatibility.

    Who will handle the chemical? Employee or contractor? Job title of TSHJ Subcontractor = 10 Employees
    employee? How many employees/contractor employees will be handling the
    chemical per shift?

    Remarks by Industrial Hygiene &


    Submitted Team Leader (of Environment Sections
    by submitting division)
    Signature Date

    Team Leader,
    Warehouse
    Signature Date

    Reviewed Environment
    Environment

    by Section
    Signature Date
    Health &

    Industrial
    Hygiene
    Section Signature Date

    Approved Team Leader, Health


    by & Environment
    Signature Date

    Note 1. Assistance may be sought from Industrial Hygiene & Environment Sections of Health & Environment Team for
    risk assessment.

    Title: Chemical Hazard Management Rev. 0 Ref. No. KIPIC/HSESF/SYSOH/18/1602


    Date of Issue: October 2018 [Page 36 of 58] Next Review Date: October 2021

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