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<br />Chemical Storage and Handling <br /> <br />Version #: 2.2 Date Revised: 09/28/2023 Page 3 of 4 <br /> <br /> <br />Chemical Removal Request <br /> <br /> Chemical Removal <br /> Chemical Replacement <br /> <br />Chemical Name: <br />Manufacturer Name: <br />Person Requesting Removal: <br />Reason for Removal: <br /> <br />1. Location and quantity of remaining stock? <br />2. Do any other Departments use this chemical?  Yes  No <br />a. Reference affected department: <br /> <br />If the answer to question two is yes, the removal will not be approved. Once all depleted stock of the chemical is <br />removed, and no other departments are affected adversely by the removal, then the request will be approved. <br /> <br />Chemical request denied <br /> This chemical is used by other departments within the company. <br /> Other: <br /> <br /> <br />By signing this document, the person requesting the removal attests that the information is correct to the best <br />of their knowledge. <br /> <br />Department Manager Signature: <br />Date Signed: <br />Safety Coordinator Signature: <br /> Approved <br /> Not Approved <br />