MESA+ University of Twente
Micro Sensors & Systems

Information card chemical experiment

 

EXPERIMENT INFORMATION CHART nr:

Start date:

Valid until:

Reaction / Type of experiment:

RISK-ASPECTS

YES / NO

Max/min.

High pressure/vacuüm

 

 

High/low temperature

 

 

Moving parts

 

 

Ionizing radiation

 

 

Electricity

 

 

 

Used Dangerous chemicals:

Mass

(g)

Vapour pressure

(mbar)

Limit

(mg/m3)

LD 50

(mg/kg)

LC 50

(mg/l)

Name

CAS-nr.

Waste category

H-sentence + description

P-sentence + description

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Experimentator*

(Wnd.) AMC*

Call when no answer:

Safety measures:

Name:

 

 

 

Tel internal:

 

 

 

Personal protection measures:

Tel outside

opening hours:

 

 

 

Nearest first aid / fire extinguish equipment:

Signature:

 

 

 

Cleaning of spilled quantities (for example neutralizing, absorbing, etc.):

Calculated KF-value:

*) I declare to have informed myself of potential risks associated with this experiment and that I have taken the appropriate safety measures, in accordance with regulations.

THIS FORM SHOULD BE AT THE WORK SITE WHEN THE EXPERIMENT IS RUNNING / PERFORMED