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INDUSTRIAL CHEMICALS (NOTIFICATION AND ASSESSMENT) REGULATIONS 1990 - SCHEDULE 1

Forms

(regulation 9)

Form 1          

APPLICATION FOR ASSESSMENT OF A CHEMICAL UNDER SUBSECTION 55 (1) OF THE INDUSTRIAL CHEMICALS (NOTIFICATION AND ASSESSMENT) ACT 1989

Name of applicant:

Address of applicant:

Details of chemical:

 

(1)

Chemical name of chemical:

(a)

(2)

Name or names by which the chemical is known:

(b)

(3)

Name or names under which the chemical is marketed by applicant:

(c)

(4)

Chemical Abstract Service Number:

(d)

(5)

Molecular formula:

 

(6)

Structural Formula:

 

(7)

Gram-molecular weight: 

 

..............................................

(Signature of applicant)

(e)

 

 

       (a)    insert the chemical name of the chemical:

                  (i)    in the case of a pure chemical:

                          (A)     the name to be used in the Australian Inventory of Chemical Substances, that is the Chemical Abstracts (CA) Preferred Index Name; or

                          (B)     if such a name is not available -- the name to be used by the International Union for Pure and Applied Chemistry; and

                 (ii)    in any other case -- as complete a description of the chemical as is practicable; and

                (iii)    in the case of a biopolymer, include a description of the biological source of the biopolymer

       (b)    insert the name or names by which the chemical is known or identified in scientific or technical literature

        (c)    insert the name or names under which applicant markets, or intends to market, the chemical

       (d)     insert the number assigned to the chemical by the service known as the Chemical Abstract Service

        (e)     insert date

Form 2          

APPLICATION FOR ASSESSMENT OF A CHEMICAL UNDER SUBSECTION 55 (2) OF THE INDUSTRIAL CHEMICALS (NOTIFICATION AND ASSESSMENT) ACT 1989

Name of applicant:

Address of applicant:

Details of chemical:

 

(1)

Chemical name of chemical:

(a)

(2)

Name or names by which chemical is known:

(b)

(3)

Name or names under which chemical is marketed by applicant:

(c)

(4)

Chemical Abstract Service Number:

(d)

(5)

Molecular formula:

 

(6)

Structural Formula:

 

(7)

Gram-molecular weight: 

 

..............................................

 

(Signature of applicant)

 

(e)  

 

       (a)     insert the chemical name of the chemical:

                  (i)    in the case of a pure chemical:

                          (A)     the name to be used in the Australian Inventory of Chemical Substances, that is the Chemical Abstracts (CA) Preferred Index Name; or

                (B)     if such a name is not available -- the name to be used by the International Union for Pure and Applied Chemistry; and

                 (ii)    in any other case -- as complete a description of the chemical as is practicable; and

                (iii)    in the case of a biopolymer, include a description of the biological source of the biopolymer

       (b)    insert the name or names by which the chemical is known or identified in scientific or technical literature

        (c)    insert the name or names under which the applicant markets, or intends to market, the chemical

       (d)    insert the number assigned to the chemical by the service known as the Chemical Abstract Service

        (e)    insert date

 


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