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Indoor Air Quality Forms 221
Building Name: ___________________________________________________ File Number: ________________________________
Address: ______________________________________________________________________________________________________
Completed by: __________________________________________________ Phone: ______________________________________
Chemical Inventory
The inventory should include chemicals stored or used in the building for cleaning, maintenance, operations, and pest
control. If you have an MSDS (Material Safety Data Sheet) for the chemical, put a check mark in the right-hand column.
If not, ask the chemical supplier to provide the MSDS, if one is available.
Sections 2 and 6 discuss pollutant sources. Section 4 discusses MSDSs.
MSDS on file?Date Chemical/Brand Name Use Storage Location(s)
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