Safety Facility Equipment Identification Catalog Page 206 Safety & Regulatory

206 Safety & Regulatory Customer Information Company Name: Name: Address1: Phone #: Address2: Fax #: City: State: Zip: Email: Distributor Information Distributor: Contact Name: Account #: Fax #: Phone #: Additional Label Content: EC #: CAS #: Index #: Reach Authorization #: Internal Reference #: Chemical Manufacturer Name: Chemical Manufacturer Address: Emergency Contact Phone #: Multiple Languages Requested* * Please indicate languages requested, then provide the necessary translations to the customer service rep after you have received the initial English proof. Label Specifications Label Content Label Material r B-302 Self-Sticking Polyester r B-946 Vinyl r B-7569 Economy Vinyl r B-235 Coated Paper Quantity and Size (minimum order qty. of 25) r 3" x 5" Qty. r 4" x 6" Qty. r 4.5" x 7" Qty. Label Package r Roll Form (100 labels minimum) r Individual Labels 3. Explosive 8. Gas Pressure 6. Acute Toxic 4. Flammable 1. Corrosive 9. Health 7. Oxidizing 2. Severe Toxic 5. Environmental GHS Pictograms: Locate on your Safety Data Sheet and indicate pictogram number below: 1 Minimum / Maximum 4 Diamond 1: Diamond 2: Diamond 3: Diamond 4: Chemical/Product Name: Signal Word: (DANGER or WARNING) Capacity: Units: Hazard Statements: Located on your Safety Data Sheet, please include H-Code if available. i.e. H100 Precautionary Statements/First Aid: Located on your Safety Data Sheet, please include P-Code if available. i.e. P100 Custom GHS Labels Order Form Custom GHS Label Form When ordering a Custom GHS Label from Brady, please have a Safety Data Sheet (SDS) in hand to fill in the form. The SDS, supplied from your chemical manufacturer must be up-to-date with GHS elements. All required label elements that are needed to fill this form out are found in sections 1-3 in your chemical SDS. (Once label has been created a proof is required.) Once complete, return this form to or fax to 1-800-292-2289.

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