MSDSReviewRequestForm.doc
DOC document 60 KB Posted
- Solicitation number
- 47PC0420B0001
About this file
This document is a request form for review of material safety data sheets (MSDS) for chemical products proposed for use in Social Security Administration facilities. The form requests information on the intended chemical including the product name, manufacturer, intended use, location and timing of use, safety controls, and other relevant details. The requester is to complete this form and submit it along with the current MSDS to specified contacts for review in accordance with the agency's hazard communication program before new chemicals are purchased or used. A separate process is outlined for review of pesticide products involving labels and application plans. Reviews are to help ensure proposed chemicals are used safely per manufacturer recommendations.
The related federal contract opportunity is a solicitation from the General Services Administration to provide design-build construction services for waterproofing exterior foundation walls and ancillary work at the Joseph P. Addabbo Federal Office Building in Jamaica, New York. Services sought include waterproofing the north and south building walls, with requirements to be met using a design-build project delivery method. The General Services Administration Public Buildings Service Region 2 is the contracting agency.
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| 47PC0420B0001 - Solicitation.pdf |
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Text version
Request for Material Safety Data Sheet (MSDS) Review
Please complete this form to request the review of an MSDS for a chemical product. In accordance with the SSA’s Hazard Communication Program, any chemical product proposed for a new use in a Headquarters or Delegated facility must be reviewed by OEHOS in advance of purchase or use. While not required, MSDS for products currently in use or proposed for use in a leased facility may also be forwarded to OEHOS for review.
If the product is a pesticide, the pesticide label and the pesticide application plan must be submitted in lieu of this form. The pesticide application plan can be obtained by contacting april.hall-hough@ssa.gov or denise.copperthite@ssa.gov. If an MSDS is available for the pesticide, it should also be submitted.
For all non-pesticide products, send this completed form and the current MSDS (either in PDF form or by attaching the link to the MSDS from the Manufacturer’s website), to April Hall-Hough (april.hall-hough@ssa.gov). Please make sure that the MSDS is legible. If you have any questions, please contact April at (410) 965-2971 or Denise Copperthite at (410) 378-0354.
PLEASE NOTE: It is SSA policy that products must ALWAYS be used in accordance with the Manufacturer’s Recommendations and MSDS. All recommended PPE must be used ANY time the product is in use.
| Date |
| Region |
| Building Name and Office Code |
| Requestor |
| Requestor’s Phone Number |
| MSDS Date |
| Chemical Name |
| Manufacturer’s Name |
*Note: Please submit the most recent MSDS from the Manufacturer’s website
1. What is the intended use of the product?
2. Will this product be used on an ongoing basis or for this single application? If it is to be used on a temporary basis, please indicate the project this product will be used for and the approximate dates on which it will be used. (e.g. cafeteria renovation March ’09)
3. Specify the location (building, indoors/outdoors, location within building) where the product will be used and where it will be stored.
4. Will this product be used during normal work hours, and if so, will it be used in occupied areas?
5. Specify any control methods that will be employed during the use or application of this product. (e.g. supplemental ventilation)
6. Please provide any other information that may be useful to expedite or clarify product review.
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