Entry Guide for "DIC RAW MATERIAL SURVEY" for Form Version 4.1
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1 Entry Guide for "DIC RAW MATERIAL SURVEY" for Form Version Find proper selection among drop-down list if explanation below is marked with "*". - You can leave from an inquiry cell empty if your SDS provides sufficient information. Thank you for your kind cooperation. I. Identification for Product and Company Sheet ID Please utilize this cells for your reference. Reporting Date [Mandatory field] Enter the date with the form : YYYY.MM.DD Product Name [Mandatory field] Enter the product name. Product Type(*) [Mandatory field] Please regard a polymer as a substance. Name of Manufacturer [Mandatory field] Enter the manufacturer's name. Be careful to avoid entering the trader's name. Name of Supplier [Mandatory field] Enter the name of the direct supplier who delivers the product to DIC. Postal Address [Mandatory field] Department [Mandatory field] Person in Charge [Mandatory field] Telephone Number [Mandatory field] Form : +"ICCC"-"Own number" (*) Facsimile Number Form : +"ICCC"-"Own number" (*) Address Department's address is desirable, otherwise personal address is available. Fire Service Act (*) [Mandatory field] In case selecting one of the "Category 1-6", please proceed further selection (*). Poisonous & Deleterious Substance Control Act (*) [Mandatory field] Narcotics & Psychotropic Control Act (*) [Mandatory field] Explosives Control Act (*) [Mandatory field] High Pressure Gas Safety Act (*) [Mandatory field] Law Concerning Protection of Ozone Layer (*) [Mandatory field] International Transportation Regulation UN Class (*) In case the selected class has a sub-class, select as similar. UN Number Enter applicable UN Number directly. If no UN Number is applicable, enter "No UN Number". Packing Grade(*) Actual Name ( in case of N.O.S.) If UN name of the dangerous good includes "N.O.S" description, enter actual name of the Act on Prevention of Marine Pollution(*) Export Trade Control Order (*) [Mandatory field] 1
2 Inquiry takes place each by each for Appended Table 1 and 2 respectively. Note : Definition for "N.A." and "Not subject" are as follows; N.A. : Name of the product or its part is listed in the table, however not applicable to the statement precisely. Not subject : Name of the product or its part is not listed in the table. If you select "Applicable" or "N.A.", go to further inquiry as well as please attach a parameter sheets and check sheets. Incase two or more items are subject to judgment, list them with "," instead of pause(s). HS Code HS Code: Harmonized Commodity Description and Coding System Enter the first 2-digit at least. Provision of additional 2-digit is appreciated. Provision of whole 6-digit is highly appreciated. Version Select referred year version. GHS Classification (*,#) Note : Definition for "Not subject to classification", "Out of classification" and "Unable to classify" are as follows; Not subject to classification : No need to judge. (e.g., solid goods is not subject to "Oxidizing Gases") Out of classification : Subject to classification but not applicable, i.e., hazardous level is lower than threshold. Unable to classify : Subject to classification but impossible to judge because of data lacking, unreliable data, etc. Remarks or special statement, if any If you have any statement to highlight, use this field. If no, leave it empty. II. Information for Chemical Composition (*) Chemical Composition Please list all chemical substances in your product. You can keep information confidential if content of a substance is less than 0.1% by weight in your product. However, please disclose information if a substance in your product is applicable to any of the following; intentionally employed substance, either Class 1 Specified Chemical Substance or Monitored Chemical Substance in Chemical Substance Control Law and a specified substance in Housing Performance Indication System. Chemical Substance Name Enter IUPAC name as possible. CAS No. Enter CAS number. In case no CAS number exists, enter "No CAS". If you do not intend to disclose CAS number, please enter "Exists". Content (*) Enter content in % at fixed value as possible. If range description is required, enter according to the form such as NN.N-NN.N, >=NN.N or Containing without intention (*) Select "without intention" if applicable. Keep empty if not. Note) Without intention : Incorporated substance which is not added intentionally, e.g., impurities in raw materials, Chemical Substances Control Act - Registration Status (*) [Mandatory field] Possess MITI No. Before publishing in Official Gazette Low production volume/new Low volume/new 2
3 Intermediate Polymer with low concern R&D use Not Subject to the Act : e.g., Natural substance Chemical Substances Control Act - Controls Division (*) [Mandatory field] Class I specified chemical substance Class II specified chemical substance Monitored chemical substance Priority assessment chemical substance Industrial Safety and Health Act - Registration Status (*) [Mandatory field] Existing substance Please also enter Official Gazette reference No. into cell below. In case of a specified polymer regarded as an existing substance, select "Existing substance" Low volume/new R&D use Not registered yet Not subject to the Act : e.g., Article Industrial Safety and Health Act - Controls Division (*) [Mandatory field] Group I specified chemical substance Group II specified chemical substance Substance subject to be indicated its name and to be notified Carcinogenic substance Mutagenic substance Pollutant Release and Transfer Register (PRTR) (*) Select among followings if applicable. Class I designated chemical substance Class II designated chemical substance Specified class I designated chemical substance Conversion Factor to Element Please enter conversion factor to element such as "Pb=38.4%" at the cell below, in case legally required. In case containing two or more elements, enter such as "Sb=5.5%,Bi=0.15%". Please also note cyan(cn) is regarded as an element in this Law, i.e., conversion factor is required. Elements Required Conversion Factors Legally Zn in water soluble zinc compounds Sb in antimony itself or antimony compounds In in indium itself or indium compounds Cd in cadmium itself or cadmium compounds Ag in silver itself or its water soluble compounds Cr in chromium itself or chromium(iii) compounds Cr in chromium (VI) compounds Enter as "Cr6+=n%" Co in cobalt itself or its compounds CN in inorganic cyanide Hg in mercury itself or its compounds Sn in tin itself or its organic compounds Se in selenium itself or its compounds Cu in water soluble copper salts Pb in lead compounds Ni in nickel compounds As in arsenic itself or its inorganic compounds F in hydrogen fluoride or its water soluble salts Be in beryllium itself or its compounds B in boron itself or its compounds Mn in manganese itself or its compounds Mo in molybdenum itself or its compounds Status for Other Legislations or Industrial Standards Give information if applicable to any regulations/industrial standards. 3
4 III. Information on Inventory Countries shown below have own inventory systems. In this sheet status under the inventory is inquired. Select status from drop-down lists. There may be further inquiry according to the selection. For compositions without disclosure of CAS numbers, show status accurately as possible. In case CAS number is disclosed, is acceptable. United States : Toxic Substances Control Act (*) "Polymer exemption" "Not subject to TSCA" SNUR "N.A. to SNUR" "Applicable to SNUR" Canada : Environmental Protection Act (*) "Listed in DSL" "Listed in NDSL" EU : Registration, Evaluation, Authorization and Restriction of Chemicals (*) "Registration completed or intended" "Polymer composed of registered/reg. intended monomers" "Neither registered nor intended" "Not subjected to the REACH (Article)" Switzerland : Chemicals Act (*) "Listed in EINECS" "Listed in product inventory" "Listed in NLP" "Polymer with no notification requirement" "Not registered yet" Australia : Industrial Chemicals Act (*) New Zealand : Hazardous Substance and New Organisms Act (*) South Korea : K-REACH (*) "Existing substance" "Existing substance subject to registration" "Not subject to K-REACH" South Korea : Industrial Safety and Health Act (*) "Existing substance" "Not subject to EHS Act" 4
5 South Korea : Chemicals Control Act (*) "N.A. to hazardous substance" "Hazardous substance" "Restricted substance" "Prohibited substance" "Permitted substance" China : Registration of New Chemical Substance (*) Taiwan : Toxic Chemical Substances Control Act/Occupational Safety and Health Act (*) Philippine : Toxic Substances and Hazardous and Nuclear Wastes Control Act (*) "Exempted (polymer)" Thailand : (Act has not been named) (*) "Listed in pre-inventory" "5.6notified" Judgment for Export (at the point of inventory) (*) Judge if your product can be exported with compliance to each country. Select from "Export possible", "Export possible under condition", "Export impossible" and. Attention and Remarks Please revise this Material Survey Sheet as soon as possible if applicable to followings; - Any new information is provided by suppliers causes necessity for revision. - Any new information is obtained by analysis causes necessity for revision. - Any new information is obtained via other measure causes necessity for revision. [Reference] Helpful websites Note : Please be careful that the URLs below may be changed, or a new URL is possibly created without deleting the expired one. - e-gov: Legal data supply system, Ministry of Internal Affairs and Communications (Japanese Only) - Regulatory Information search at JCIA BIGDr, Japan Chemical Industrial Association's site - NITE Chemical Risk Information Platform (NITE-CHRIP) - Japan Advanced Information Center of Safety and Health (Japanese Only) - Japan Chemicals Collaborative Knowledge Database (J-CHECK) Chemical Substances Control Act - A scheme that facilitates sharing information on chemical substances in products (chemsherpa) 5
6 - Trade Statistics of Japan Ministry of Finance 6
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