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Chemical / Product [You must fill out all fields for each chemical you specify]
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
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Cardboard
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Metal
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# of Containers
Total Weight (lbs.)
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Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
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Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
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# of Containers
Total Weight (lbs.)
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Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
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Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
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Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
Add Another?
Chemical/Product
Phase
Solid
Liquid
Gas
Hazard Classification
Explosive (1)
Flamable Gas (2.1)
Non-Flammable Gas
Poisonous Gas (2.3)
Flammable (3)
Flammable Solid (4.1)
Spontaneously Combustible (4.2)
Water Reactive (4.3)
Oxidizer (5.1)
Organic Peroxide (5.2)
Posionous (6.1)
Infectious (6.2)
Radioactive (7)
Corrosive (8)
Miscellaneous (9)
Corrosive (8) / Flammable (3)
Corrosive (8) / Posionous (6.1)
Flammable (3) / Posionous (6.1)
Controlled Substance
Container Type
Cardboard
Fiber Drum
Glass
Metal
Plastic
# of Containers
Total Weight (lbs.)
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