REGISTRATION OF A DANGEROUS CHEMICAL1111

Republic of Mauritius
MINISTRY OF HEALTH & QUALITY OF LIFE
DANGEROUS CHEMICALS CONTROL BOARD

Atchia Building
Suffren Street, Port Louis

DANGEROUS CHEMICALS CONTROL ACT 2004
ACT NO. 16 OF 2004

APPLICATION FOR THE REGISTRATION OF A DANGEROUS CHEMICAL

INFORMATION TO APPLICANT

1. The application form must be duly completed in all respects. Where applicable, the
requested information should be submitted as separate numbered attachments.

2. The application and draft label must be submitted in 17 copies with an explanatory
covering letter.

3. Every application must be accompanied by the prescribed fee.

4. The Board may require the applicant to furnish such additional information as may be

required to determine the application.

1. APPLICANT Name/ Corporate name of Name of distributor/ agent
Identification company in country
Status(importer, distributor) Reg. No.
Physical address
Postal address
Telephone
Fax
e-mail

2. IDENTIFICATION OF THE SUBSTANCE
Name (EINECS or IUPAC)
Common name
CAS NO
HS CODE
Synonyms
Molecular formula
Structural formula
Purity(w/w)
Significant impurities or additives
Known uses

3.COMPOSITION AND INFORMATION ON INGREDENTS
Name of chemical identity CAS NO % by Weight
a)
b)

4. PHYSICO-CHEMICAL CHARACTERISTICS
Physical form
Molecular weight
Melting point (O C)
Initial boiling point(O C)
Decomposition temperature
Vapour pressure (Pa ( OC)
Relative density (g/cm3)
Vapour density (air=1)
Fat solubility (mg/kg)
Water solubility (mg/kg)
Partition coefficient (log Pow)
Flammability flash point (oC)
Explosivity
Oxidizing properties
Other physico-chemical properties

5. HEALTH AND ENVIRONMENT CHARACTERISTICS
ACUTE TOXICITY
Oral
Inhalation
Skin
Skin irritation/corrosion
Serious damage to eye/ eye irritation
Skin and respiratory sensitization
TARGET ORGAN/SYSTEMIC TOXICITY FOLLOWING SINGLE OR REPEATED
EXPOSURE
Toxicity following single exposure
Toxicity following repeated exposure
Carcinogenicity
Mutation in germ cell
Reproductive toxicity-fertility
Reproductive toxicity-developmental
toxicity

6. EMERGENCY PROCEDURES IN CASE OF ACCIDENTAL EXPOSURE OR
POISONING
Symptoms of human poisoning
First aid treatment
Skin contact
Eye contact
Inhalation
Ingestion
Antidote
Note to physician
7. EMERGENCY PROCEDURES/ CASE OF FIRE / SPILLAGE
Fire fighting measures
Procedures in case of spillage
8. HANDLING AND STORAGE
Precaution for safe handling
Condition for safe storage
9. PERSONAL PROTECTION
Respiratory protection
Hand protection
Eye protection
Skin protection
10. STABILITY AND REACTIVITY
State the stability of the substance
Conditions to avoid example light, shock ,
etc…
Incompatible material example water, air,
acid, oxidizing agents
Hazardous decomposition products

11. ECOLOGICAL INFORMATION(Describe the most important characteristics likely
to have an effect on environment)
ecotoxicity
Persistence and degradability
Bioaccumulation potential
Mobility in soil
Other adverse effects

12 OTHER INFORMATIONS
Transport information
Disposal information
Training advice
Recommended uses and advice
Minimum label requirements

13 DECLARATION
For and on the behalf of………………..
I hereby certify that the above mentioned information and data in support of this
application are to the best of my knowledge true, correct and complete

Name in full & Official title signature

Date Official stamp of applicant/ company

The applicant should forward a photocopy of the SDS.