HCP-1 REQUEST FORM FOR MATERIAL SAFETY DATA SHEETS Send to: Department of Radiological & Environmental Management Civil Engineering Room B173E EMPLOYEE NAME (PLEASE PRINT) PHONE DEPARTMENT FAX BUILDING/ROOM MSDSs REQUESTED (Please Print or Type) Chemical/Product Name & Product/Catalog No. Manufacturer & City/State/Phone No. Employee Signature Date Supervisor Signature Date --------------------DO NOT MARK BELOW THESE LINES-------------------- FOR OFFICE USE ONLY MSDS Request Processed By: IH, IH Technician or DTI Date 30