Commonwealth Numbered Regulations

1993 No. 35 INDUSTRIAL CHEMICALS (NOTIFICATION AND ASSESSMENT) REGULATIONS (AMENDMENT) - REG 8

8.1 Before Form 1, insert:
                             Form 1A                Regulation 7AA

INDUSTRIAL CHEMICALS (NOTIFICATION AND ASSESSMENT) ACT 1989
STATEMENT UNDER REGON 24A REGARDING A
SYNTHETIC POLYMER OF LOW CONCERN
Applicant Details
Business Name:
Business Address (including postcode):
    Phone (  )             Fax (  )

Technical Contact
Name
Position
    Phone (  )             Fax (  )

Details of Polymer
Chemical Name of Polymer:
Other Names:
Marketing Name:
    CAS Number (if known):     -  -

Justification for application under the Synthetic Polymer of Low
Concern Category
Does the polymer meet the criteria for a polymer of low concern in
regulation 4A of the Industrial Chemicals (Notification and
Assessment) Regulations?
                                                         Yes       No

    (a)    number average molecular weight

    (b)    charge density

    (c)    residual monomer content

    (d)    dissociation constant

    (e)    water solubility

    (f)    particle size for solids

    (g)    stability; and

    (h)    reactive functional groups

Molecular Formula:
Structural Formula:
Means of identification (List of spectral data available):
Number Average Molecular Weight (MWn):
Weight Percentage of polymer species with:
MWn <1000:

MWn <500

Does the polymer contain any positively or negatively charged groups?
For polycationic polymers please provide a calculation of the charge
density (No. charges per 1000 MW) or the equivalent weight of charged
groups (1000/charge density per 1000 MW)
Will the polymer be cationic or anionic at pH range (4-9) likely to be
encountered in the environment?
Table 1: List of Polymer Constituents
    Constituent         CAS No.             % Weight

Table 2: Maximum Weight-Percentage of Residual Monomers and Impurities
    Monomer or Impurity                     % Weight

Water Solubility:
Particle Size Distribution:
Comment on the stability of the polymer:
Does the polymer contain any functional groups which are intended or
can reasonably be anticipated to undergo further reaction? If so,
give details:
Intended Use(s):
Appearance of the Polymer:
Estimated Manufacture or Import Volume (during each of the first five
years):
Site of Manufacture or Reformulation:
Melting Point:
Density:
Flammability Limits:
Autoignition Temperature:
Explosive Properties:
Reactivity (eg. oxidation potential):
Occupational Health and Safety
What is the likely occupational exposure? Give details of:

   (a)  data about occupational exposure factors, that is to say:

        (i)    the number, and categories, of workers to be involved in
working with the polymer; and

        (ii)   the nature of the work to be done by them; and

        (iii)  the safety procedures to be observed when handling the
polymer; and

        (iv)   a brief description of the training and education in safe
working practices to be given to those workers; and

        (v)    data about the occurrence of work related injuries and diseases
affecting workers dealing with the polymer; and

        (vi)   any other data relating to occupational hazard associated with
the chemical; and

   (b)  a list of health conditions (if any) which indicate that the
polymer should not be used; and

   (c)  particulars of procedures for atmospheric monitoring and
biological monitoring of the effects of the polymer; and

   (d)  information held, or reasonably obtainable, by the notifier
about studies and observations of health problems or adverse symptoms
occurring in humans exposed to the polymer. Environmental Impact What is the
likely environmental impact? (Provide information about the release of the
polymer likely to occur at the manufacturing or reformulating site.) Public
Health What is the likely public health exposure? (Provide a brief description
of any way in which the chemical could be harmful or hazardous to the health
of the public at large.) Label Give particulars of the labels in the presented
form to be affixed to products consisting of or containing the polymer.
(Attach a copy of the label.) Material Safety Data Sheet Give particulars of
the proposed Material Safety Data Sheet for the polymer, and for all
commercially available products, or substances used in the workplace,
containing the polymer. (Attach a copy of the proposed Data Sheet.)
Declaration I declare that to the best of my knowledge all the information in
this form and attachments is true, correct and complete. I also declare that I
am in possession of, and have ready access to, the raw data and am entitled to
use and to give the Director all information contained in this application.
Name: Position:
Signature:                        Date:
NOTE: It is an offence under the Act to supply a statement which is false or
misleading.