!!! '"$() *( + "$(, *$-$+(.$*'$-( ),*,(. +) $* ) $-$.,$!!! /00"12"%343!!!,5*167&8 %!48!989
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14 ,/ CODE OF SECTOR CODE 1 MANUFACTURING 2 MINING AND QUARRYING 3 CONSTRUCTION 4 AGRICULTURE 5 FORESTRY 6 FISHERY 7 LOGGING 8 ELECTRICITY UTILITY 9 GAS UTILITY 10 WATER UTILITY 11 SANITARY UTILITY 12 TRANSPORT 13 STORAGE 14 COMMUNICATION 15 WHOLESALE 16 RETAIL TRADES 17 HOTELS 18 RESTAURANTS 19 FINANCE 20 INSURANCE 21 REAL ESTATE 22 BUSINESS SURVICES 23 PUBLIC SURVICES 24 STATUTORY AUTHORITIES TYPE OF SECTOR
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
20 ($+$(, &% %& (- ))*,$(, * 9!!6 (*($-5$*0 7%!%% ($(,$-" 'A*(($,*) *(L, 64%4! (,*''2,*2 &! % (,*),*,*2 (($*''2,*2 &! (,*.-,*2 &9! (,*)-(,*2 &9!% (,*),(,*2A5-$0),(,*2 &7%% ( 5$ %%%% ( 5$,2$,2$((( C %! ( 5 ) $*+$( &%4!! ($L-$*'(,($2*, 9%6%% (.A(5,*'(, &::%! ) 5--$) $0,*2 &6!64 L(,*$.L, 6&&! G $(- 0A/G -."$, " 6:%4! G $(($*" ( 6% C! G$(G 0""-. 4!!! G-+$,*(,((, * 6&4!! G,*,*'(, &%&!
21 APPENDIX 4 REGISTER OF CHEMICALS HAZARDOUS TO HEALTH SECTION A : COMPANY INFORMATION Name : S Y A R I K A T R K S S D N B H D DOSH Registration No. : S L K Address : 3 3 L I G H T I N D U S T R I A L A R E A (Refer to Appendix 4 for Code of Sector and Appendix 5 for Class of Industry) Code of Sector : 0 1 City : S E T A P A K Postcode : Class of Industry : State : W P E R S E K U T U A N Company Activity (Please enter ( / ) in the appropriate box : Telephone No. : Manufacturer Distributor : Formulator : S S S S P O. J A R I N G. M Y Importer End-User : : /
22 SECTION B : LIST OF CHEMICALS HAZARDOUS CHEMICAL TO HEALTH Location : F I N I S H E D P R O D U C T No. of Hazardous Chemical : 3 No. of Workers : Male : 4 Process Operation : F I L L I N G Female : 3 Product Name Name of Chemical Physical Form of Chemical No. of Worker Exposed Type of Control Measures Engineering Control PPE Type Usage Of Chemical Quantity CAS No. Name of Active Ingredients Comply with Classification, Packaging and Labelling Regulation, 1977 CSDS (Y/N) Class Label (Y/N) Name, Address of Supplier and Contact Number (Tel. No/ ) Unleaded Gasoline - Premium grade Not applicable L 3 PVC Glove P 250 m3/mth Gasoline Benzene Y Y Y Y Y Y XYZ Malaysia Sdn Bhd, 27 Jln Ipoh, K. Lumpur Tel. No SAP 9436 Not applicable L 2 Respirator P 3500 m3/mth xylene Y Y Y AAA Malaysia Sdn Bhd, Lot 21 Senawang Industrial Estate, N. Sembilan Tel. No SECTION C : NAME OF PERSON WHO PREPARED OF REVIEWED PREPARED BY : REVIEWED BY : Name : A L I A H M A D Name : L I M M O I L E N G Title : S U P E R V I S O R Title : P R O D M A N A G E R Date : Date : (Signature) (Signature)
23 APPENDIX 5 REGISTER OF CHEMICALS HAZARDOUS TO HEALTH SECTION A : COMPANY INFORMATION Name : DOSH Registration No. : Address : (Refer to Appendix 4 for Code of Sector and Appendix 5 for Class of Industry) Code of Sector : City : Postcode : Class of Industry : State : Company Activity (Please enter ( / ) in the appropriate box : Telephone No. : Manufacturer Distributor : Formulator : Importer End-User : :
24 SECTION B : LIST OF CHEMICALS HAZARDOUS CHEMICAL TO HEALTH Location : No. of Hazardous Chemical : Process Operation : No. of Workers : Male : Female : Product Name Name of Chemical Physical Form of Chemical No. of Worker Exposed Type of Control Measures Engineering Control PPE Type Usage Of Chemical Quantity CAS No. Name of Active Ingredients Comply with Classification, Packaging and Labelling Regulation, 1977 CSDS (Y/N) Class Label (Y/N) Name, Address of Supplier and Contact Number (Tel. No/ ) SECTION C : NAME OF PERSON WHO PREPARED OF REVIEWED PREPARED BY : REVIEWED BY : Name : Name : Title : Title : Date : Date : (Signature) (Signature)
25 SECTION B : LIST OF CHEMICALS HAZARDOUS CHEMICAL TO HEALTH Location : No. of Hazardous Chemical : Process Operation : No. of Workers : Male : Female : Product Name Name of Chemical Physical Form of Chemical No. of Worker Exposed Type of Control Measures Engineering Control PPE Type Usage Of Chemical Quantity CAS No. Name of Active Ingredients Comply with Classification, Packaging and Labelling Regulation, 1977 CSDS (Y/N) Class Label (Y/N) Name, Address of Supplier and Contact Number (Tel. No/ )
26 Product Name Name of Chemical Physical Form of Chemical No. of Worker Exposed Type of Control Measures Engineering Control PPE Usage Of Chemical Type Quantity CAS No. Name of Active Ingredients Comply with Classification, Packaging and Labelling Regulation, 1977 CSDS (Y/N) Class Label (Y/N) Name, Address of Supplier and Contact Number (Tel. No/ ) SECTION C : NAME OF PERSON WHO PREPARED OF REVIEWED PREPARED BY : REVIEWED BY : Name : Name : Title : Title : Date : Date : (Signature) (Signature)
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