Appendix C - Hazardous Facility Screening Procedure Attachment C3: Hazardous Substance Worksheet 1. Substance Description Substance Name Proprietary Name and Supplier Substance Form (Gas, liquid, solid, powder) 2. Available Information (Extract from packaging material, MSDS, UN Recommendation for the Transport of Dangerous Goods (8th edition) UN Number UN Primary Class UN Subsidiary Class Packaging Group(s) 3. Additional Information Requirements Data Source Physical parameters Initial boiling point (C) o Flash point (C) o Specific gravity @ (20C) o Molecular weight Vapour pressure (mm Hg at 20C) o Toxicity Data8 Oral toxicity LD (mg/kg) 50 Dermal Toxicity LD (kg) 50 Inhalation Toxicity LC (ppm) 50 Carcinogen9 (yes/no) Ecotoxicity Data10 LC (Salmonid fish) (mg/l) 50 EC (Daphnia) (mg/l) 50 EC (Algae) (mg/l) 50 BOD (mg/kg) 5 Pesticide (yes/no) Other 8 List lowest level available for human or mammalian species, type of species, test duration and data source. 9 See Appendix B, Land Use Planning for Hazardous Facilities, June 1995. 10 For LC50 and EC50 list lowest levels for indicated or other aquatic species, type of species and data source. App C - 13