Annex 7 Telext/Telefax format for proposing tripartite agreement for provisional assessment of liquid substances

  1 NAME OF SUBSTANCES

  2 PROPOSED HAZARD PROFILE:

• 2.1 [ ] in composite hazard profile list

• 2.2 [ ] by analogy to:

• 2.3 [ ] by data (provide relevant data)

• 2.4 [ ] by calculation (mixture)

  3 Proposed pollution category:

  4 Proposed ship type (pollution hazard):

  5 Melting point:

  6 Viscosity at 20°C:

 Safety

  7 Vapour pressure at: °C

  8 Boiling point: °C

  9 Relevant toxicity:^footnote

  10 Flashpoint: °C open/closed cup

  11 Chemical property:^footnote

  12 Minimum carriage requirements:^footnote

• d. .........................................................

• e. (Ship type given here may override 4 above)

• f. .........................................................

• g. .........................................................

• h. .........................................................

• i. .........................................................

• j. .........................................................

• k. .........................................................

• l. .........................................................

• m. .........................................................

• n. .........................................................

• o. .........................................................

  13 Remarks: Please indicate, if possible, other relevant data.