You are on page 1of 13

6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Go digital today!
Convert your paper checklists into digital forms
Scan this QR code to use this paper checklist on your smartphone or
tablet or visit https://safetyculture.com/

Title Page

Conducted on 

Prepared by

Name of Chemical

Location 

SECTION 1: IDENTIFICATION

1.1 Product Identifier

Product Form

Product Name

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 1/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Synonyms

1.2 Intended Use of the Product

Use of the substance/mixture

1.3 Name, Address, and Telephone of the Responsible Party/Company

Emergency Telephone Number

SECTION 2: HAZARDS IDENTIFICATION

2.1 Classification of the Substance or Mixture (GHS-US Classification)

2.2 Label Elements (GHS-US Labeling)

Hazard Pictograms (GHS-US) 

Signal Word (GHS-US)

Hazard Statements (GHS-US)

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 2/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Precautionary Statements (GHS-US)

2.3 Other Hazards

2.4 Unknown Acute Toxicity (GHS-US)

SECTION 3: COMPOSITION/INFORMATION ON INGREDIENTS

3.1 Substance

3.2 Mixture (Include percentage of components)

Component (include percentage & GHS-US classification)

Chemical component

Full text of H-phrases: see section 16

SECTION 4: FIRST AID MEASURES

4.1 Description of First-aid Measures

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 3/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

4.2 Most Important Symptoms and Effects Both Acute and Delayed

4.3 Indication of Any Immediate Medical Attention and Special Treatment Needed

SECTION 5: FIRE-FIGHTING MEASURES

5.1 Extinguishing Media

5.2 Special Hazards Arising From the Substance or Mixture

5.3 Advice for Firefighters

SECTION 6: ACCIDENTAL RELEASE MEASURES

6.1 Personal Precautions, Protective Equipment and Emergency Procedures

6.1.1 For Non-Emergency Personnel

6.1.2 For Emergency Personnel

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 4/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

6.2 Environmental Precautions

6.3 Methods and Materials for Containment and Cleaning Up

6.4 Reference to Other Sections

SECTION 7: HANDLING AND STORAGE

7.1 Precautions for Safe Handling

7.2 Conditions for Safe Storage, Including Any Incompatibilities

7.3 Specific End Use(s)

SECTION 8: EXPOSURE CONTROLS/PERSONAL PROTECTION

8.1 Control Parameters

8.2 Exposure Controls

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 5/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

8.2.1 Appropriate Engineering Controls

8.2.2 Personal Protective Equipment (PPE)

Include photos or pictograms of PPEs 

8.2.3 Materials for Protective Clothing

8.2.4 Environmental Exposure Controls

8.2.5 Other Information

SECTION 9: PHYSICAL AND CHEMICAL PROPERTIES

9.1 Information on Basic Physical and Chemical Properties

Physical State

Appearance

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 6/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Odor

pH

Evaporation Rate

Melting Point

Freezing Point

Boiling Point

Flash Point

9.2 Other Information

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 7/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

SECTION 10: STABILITY AND REACTIVITY

10.1 Reactivity

10.2 Chemical Stability

10.3 Possibility of Hazardous Reactions

10.4 Conditions to Avoid

10.5 Incompatible Materials

10.6 Hazardous Decomposition Products

SECTION 11: TOXICOLOGICAL INFORMATION

11.1 Information on Toxicological Effects

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 8/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

SECTION 12: ECOLOGICAL INFORMATION

12.1 Toxicity

12.2 Persistence and Degradability

12.3 Bioaccumulative Potential

12.4 Mobility in Soil

12.5 Other Adverse Effects

SECTION 13: DISPOSAL CONSIDERATIONS

13.1 Waste Treatment Methods

SECTION 14: TRANSPORT INFORMATION

14.1 In Accordance with DOT

Proper Shipping Name

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=1687937888… 9/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Hazard Class

Identification Number

Label Codes

Packing Group

ERG Number

14.2 In Accordance with IMDG

Proper Shipping Name

Hazard Class

Subsidiary Risk(s)

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=168793788… 10/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Identification Number

Packing Group

Label Codes

EmS-No. (Fire)

EmS-No. (Spillage) S-C

MFAG Number

14.3 In Accordance with IATA

Proper Shipping Name

Packing Group

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=168793788… 11/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Identification Number

Hazard Class

Label Codes

Subsidiary Risk(s)

SECTION 15: REGULATORY INFORMATION

15.1 US Federal Regulations

15.2 US State Regulations

SECTION 16: OTHER INFORMATION, INCLUDING DATE OF PREPARATION OR LAST REVISION

Other Information

GHS Full Text Phrases

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=168793788… 12/13
6/28/23, 8:39 AM Safety Data Sheet Template - SafetyCulture

Disclaimer:

This information is based on our current knowledge and is intended to describe the
product for the purposes of health, safety and environmental requirements only. It
should not therefore be construed as guaranteeing any specific property of the product.

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's
solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice.
You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should
independently determine whether the template is suitable for your circumstances.

https://public-library.safetyculture.io/products/safety-data-sheet-template?amp_dev=f4544260-1cb4-49ab-b230-912a7192dc5e&sid=168793788… 13/13

You might also like