Workbook for Designated Substance Assessments
10
366-BPV-01-IMOT © 2024, Workplace Safety & Prevention Services (WSPS)
1 877 494 WSPS (9777) | 905 614 1400 | WSPS.CA
APPLICATION – WORKSHEET 1: IS THE DESIGNATED SUBSTANCE PRESENT?
1. Do any safety data sheets from your suppliers indicate the presence of the substance?
YES NO
2. If substance is present, indicate the department where it is used, nature of the use (i.e. direct or indirect)
and the quantity purchased per month or year:
Product Name Department
How Used?
Direct/Indirect
Container
Type/Size
Quantity used
per Month/year
Note: If you require more space for additional information, please go to pages 28-29.
WSPS.CA