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Rochester Hills Form Center

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Chemical Survey

  1. Indicate whether your site uses or produces any of the chemical types listed. Check all categories that apply when a chemical has more than one characteristic: e.g., both a Class 3 Flammable and a Class 6 Poison. Each chemical group listed in this survey includes a specified quantity. Chose the amount of each chemical you have on your site. To complete the survey, you may need to reference your Material Safety Data Sheets or other reporting forms.


    Do not leave blanks. Chose "Do not have" if you do not a particular type of chemical.


    When there is a substantial change in the quantity of a specific chemical on your site, a revised survey must be submitted to the Fire Department.

  2. Leave This Blank:

  3. This field is not part of the form submission.


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