Appendix 5 Hazmat Inventory Sheet

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Kingdom of Saudi Arabia

Ministry of Health
Home Medical Care Administration
Directorate General of Health Affairs in …........... Region
Home Medical Care Unit at ……………. Hospital

HAZMAT INVENTORY LIST & INFORMATION SHEET

Department : HHC Responsible Person : Safety Officer Phone Number : Revision Date :

Chemical Name Common/Trade Manufacturer Typical Physical or Personnel Frequency of MSDS on Emergency
Name Quantity on health involved with Use File Procedure
Hand Hazard Substance Required (if any)
(estimate) (List)
Chlorhexidine Medisol spray Avalon Flammable, Nursing Staff daily yes spill clean-up kit ,
Gluconate 0.5% Pharma Toxic, Standard Operating
in 70% Isopropyl Carcinogen, Procedure for
Alcohol Reproductive cleanup/evacuation
Toxin
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HMC-MSE-FORM-4.1

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