HAZARDOUS CHEMICAL SUPERVISOR

(COMPANY LOGO) (COMPANY NAME) Doc Ref:

Site: TUBATSE ALLOY SMELTER Doc Version: 001

HAZARDOUS CHEMICAL SUBSRANCE REGULATION 9 & 12

HAZARDOUS CHEMICAL INSPECTPOR

I, ______________________________ (OSH Act 16(2) appointee) the duly assigned person in terms of Act 85 of 1993, for
____________________________________________ do hereby appoint: ______________________________________________________ as
the *Competent person to supervise the storage and usage of any hazardous chemical substance used at TUBATSE ALLOY SMELTER to be
responsible for the following:

Name of Company : __________________________________________

Address: TUBATSE ALLOY SMELTER

Special Instructions/Information: ____________________________________________________________________________________________

1 Ensure that all chemicals are recorded on the hazardous chemical register.
2 Ensure that all hazardous chemicals are accompanied by the MSDS.
3 Ensure all employees who work with the chemicals are trained on the MSDS to ensure their safety while working with chemicals.
4 Ensure that all requirements are in place when using chemicals

_____________ ____________________ ____________ __________

Name Signature Designation Date

ACCEPTANCE

I,_______________________________________________ hereby accept the above designation and confirm that I have the necessary knowledge
and experience to meet the requirements of the Hazardous Chemical Substances regulations of the Occupational Health and Safety Act (85 of
1993).

_____________ ____________________ ___________________ __________

Name Signature ID Number Date