HSSE EVALUATION

REPORT

Project Modifikasi Instalasi Reverse Osmosis

(Ro) Dengan Penambahan Demin System Di
Utility Pertamina Unit Jakarta - Lubricant
 Daftar Isi

I. Pre Job Activity

II. HSE Performance Report
III. Tool Box Meeting
IV. HSSE Commitment
V. Medical Check Up dan Asuransi
VI. Kompetensi HSE Man
VII. Rambu- Rambu dan Selogan HSE
VIII. Alat Pelindung Diri
IX. Safety Induction
X. Surat Izin Kerja dan JHSEA
XI. Struktur Organisasi
XII. Inspeksi Alat Kerja Tangan
XIII. Prosedur (TKO/TKI)
XIV. Material Safety Data Sheet
PRE JOB ACTIVITY
HSE Performance Report
LAPORAN BULANAN UNJUK KERJA HSSE Kontraktor : PT. PRAKARSA ENVIRO INDONESIA
PT PERTAMINA LUBRICANTS Pekerjaan : PENAMBAHAN DEMIN SISTEM …
TAHUN Lokasi : UTILITY UNIT PRODUCTION JAKARTA
Maret 2020 No. Kontrak : Kpts 001/PL2110/2019-S7

1 MANHOURS Total man Power 5

Man-hour bulan ini 1 6 8 Total YTD 1 6 8
2 LTIR Bulan ini 0 Total YTD 0

3 CATATAN TEMUAN KESELAMATAN KERJA CATATAN TEMUAN KESEHATAN & LINGKUNGAN

Bulan ini Total Y T D Bulan ini Total Y T D
a Rekaman kasus Near-miss 0 0 a. Fit 1 00 % 1 00 %

b. Kasus P3K/First Aid 0 0 b. Fit dengan catatan 0 % 0 %

c. Medical Treatment Case 0 0 c. Unfit 0 % 0 %

d. Restricted Work Case 0 0 d. Reportable Spill > 15 bl 0 0

e. Lost Time Accident 0 0 e. Non Reportable Spill < 15 bl 0 0

f. Kematian/Fatality 0 0

4 Komunikasi, Informasi, dan Edukasi K3L

a. Orientasi/Induksi K3L Total pekerja mengikuti Orientasi/Induksi K3L 5
b. Rapat K3L Bulan ini 0 Total YTD 0
c. Toolbox Meeting/Pre Job Meeting HSE Bulan ini 4 Total YTD 0
d Kampanye K3L
1 Kampanye Keselamatan Bulan ini 0 Total YTD 0
2 Kampanye Kesehatan Bulan ini 0 Total YTD 0
3 Kampanye Lingkungan Bulan ini 0 Total YTD 0
e Pelatihan K3L
1 SIKA 0 6 5 Tatagraha/Housekeeping 0
2 STOP 0 6 Defensive Driving/Riding 0
3 Penanganan B3 0 7 P3K 0
4 Manajemen Limbah 0 8 (dan lain-lain) …

5 Inspeksi dan Audit K3L

a. Inspeksi Internal (termasuk Manajemen Puncak) Bulan ini 0 Total YTD 0
b. Inspeksi Umum Bulan ini 0 Total YTD 0
c. Inspeksi Alat Kerja Tangan Bulan ini 1 Total YTD 1
d. Inspeksi Alat Angkat dan Angkut Bulan ini 0 Total YTD 0
e. Inspeksi Kendaraan Operasional (minibus) Bulan ini 0 Total YTD 0
f. Inspeksi Elektrikal Bulan ini 0 Total YTD 0
g. Inspeksi Kebersihan dan Sanitasi Bulan ini 0 Total YTD 0
h. Inspeksi APAR Bulan ini 0 Total YTD 0

.i. Inspeksi Perlengkapan Tanggap Darurat Bulan ini 0 Total YTD 0

j. Internal Audit (SMK3L) Bulan ini 0 Total YTD 0
k. Eksternal Audit (SMK3L, Mutu, CSMS ) Bulan ini 0 Total YTD 0

6 Emergency Response Drill Bulan ini 0 Total YTD 0

7 Safety Rewards Bulan ini 0 Total YTD 0
8 Perolehan Reporting Unsafe Bulan ini 0 Total YTD 0
9 Progres Rekaman Temuan Closed Bulan Ini 0 Open YTD 0

Dilaporkan oleh: Diketahui oleh :

PT. Prakarsa Enviro Indonesia Direksi Perusahaan PT Pertamina Lubricants

Sandi Fahmi Ali Ir. Luhut Tunggul Sianturi

HSE / Supervisor Representative Direktur

Notes:
Lost Time Incident Rate (RIR) : (Total Recordable accident x 1.000.000)/Man-hours)
Lost Time Incident Rate (RIR) YTD : (Total Recordable accident-YTD x 1.000.000)/Man hours-YTD)
YTD (Year To Date)
Tool Box Meeting
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HSSE Commitment
MCU dan Asuransi
BPJS KESEHATAN KARYAWAN
Kompetensi HSE
Sandi Fahmi Ali, SKM

Profile

Date of birth : Garut / 24 - 12 – 1991

Sex : Male
Marital Status : Married
Country : Indonesian
Religion : Islam
Address : Phaniihsan II Blok D7 RT 001 RW 004 Kec. Tajurhalang, Bogor 16320

Education Organization

University of Pembangunan Nasional “Veteran” Jakarta Himpunan Mahasiswa Kesehatan Masyarakat

Jakarta (2010 – 2014) Jakarta (2012 – 2013)
Major of Occupational Health and Safety  Social Service
 Blood Donors
SMA Negeri 1 Parung  Nasional Seminar
Bogor (2007 – 2010)
Major of Sciences

SMP Negeri 1 Bojonggede

Bogor (2004 – 2007)

SD Negeri Kartika Sejahtera

Bogor (1998 -2004)

Experience Ability

PT. Prakarsa Enviro Indonesia Courses

February, 10 2020 until Now (HSE Coord)
Job Description :
 Provide Contractor Safety Management System and HSE Plan
 Support Management Representative for makesure system can
implement
 Monitoring every project that is running and monitoring all activity
in the factory
 Review risk assessment, procedure and method of work
 Occupational Health & Safety Expert by Ministry of Labor
 Risk Management “Risk Assessment” by Fairus
 Integrated QHSE (ISO 9001:2008, ISO 14001:2004 & OHSAS
18001:2007) by PT. Sinergy Solusi
 ERP in the Work Place by Fairus
 Management of Fire Safety by Fairus

PT. Jaya Consulting Management

November, 1 2018 until February, 7 2020 (HSE Inspector)
 “6 Line Toll Road in Jakarta Section A (Kelapa Gading – Pulo
Gebang : 9.30 Km)”
Job Description :
 Upgrade system management ISO
 Review risk assessment and method of work
 Control of all contractors

PT. Jaga Citra Inti

October, 3’ 2016 until July, 31’ 2018 (HSE Officer)
 “Anandamaya Residence Project”
Job Description : Skill
 Provide safety plan project incude OHS program
 Risk assessment English
 Audit internal
 Inspection on site and equipment
 Investigation accident Indonesia
 Communication with owner, consultants and main contractor.
Ms. Office
PT. Bumi Mas Jaya Perkasa
October, 1’ 2014 until September, 26’ 2016 (HSE Officer) Ms. Excel
Project :
 “Lining & Coating TBBM No 13. PT. Pertamina Tj. Priok
PowerPoint
 “Floor Coating Blending & Filling Lithos Building-Filling Line 2 PT.
Pertamina Production Unit Jakarta Pelumas”
 “Recondition The Roof Top MTS II & Switch Gear 150 KV PT.
Krakatau Daya Listrik”
 “Coating Tanki 2A PT. Pertamina Gas Dom Tj. Priok”
Job description :
 Provide Contractor Safety Management System
 Provide Health Safety Plan
 Set up KPI related OHS
 Investigation accident
 Monitoring performance OHS

sandifahmi@envirowater.id / sandifahmiali28@gmail.com 081296512258/089631528045

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Rambu-Rambu dan Selogan HSE
 Safety Sign

Foto : Rambu-Rambu
Alat Pelindung Diri
 Lembar Periksa Persediaan APD

Hari/Tanggal : Rabu, 11 Maret 2020

Lokasi : Project Penambahan Demin Sistem di Pertamina Lubricant
NO JENIS APD JUMLAH KONDISI KETERANGAN
BAIK BURUK
1 Pelindung Mata / 2 √
Safety Goggles

2 Sepatu Keselamatan / 2 √
Safety shoes

3 Topi Keselamatan / 2 √
Safety Helmet

4 Sarung Tangan / 2 √
Safety Hand Gloves

5 Pelindung Telinga / 2 √
Safety Ear Plug

6 Pelindung 2 √
Pernafasan/ Masks

7 Sabuk Keselamatan / N/A

Safety Belt

8 Kap Las / N/A

Welding Cap

9 Pelindung Wajah / N/A

Face Shield

10 Alat Penangkap Jatuh N/A

/ Full Body Harness

11 Kain Pelindung Tubuh 2 √

/ Safety Apron

Disetujui oleh: Dibuat oleh:

HSE Koordinator Petugas K3/ Petugas Gudang

F-4510-09 Rev.00
 Inspeksi

Foto : Pemeriksaan Alat Pelindung Diri

Sarung Tangan Ear Plug

Kacamata

Helmet

Kacamata

Masker

Sarung Tangan

Seragam Kerja

Apron

Sepatu Keselamatan
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Safety Induction
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Surat Izin Keja dan JHSEA
Struktur Organisasi
 Date : 10 Maret 2020
Rev : 00

PT PRAKARSA ENVIRO INDONESIA

Villa Galaxi AR 2 No. 22, BEKASI 17147 STRUKTUR ORGANISASI
Telp. (021)82432101-03; Fax. (021) 82432105
Modifikasi Instalasi Reverse Osmosis (RO) Dengan Penambahan Denim System di Utility Production Unit Jakarta – Lubricants

PROJECT MANAGER
RIZKI PASCALIS V R
082143724932
rizki.pascalis@envirowater.id

HSE

Sandi Fahmi Ali

081296512258
sandifahmi@envirowater.id

SITE MANAGER

Habson R

081252063300
habson@envirowater.id

TEKNISI TEKNISI

Andi Sanjaya
Inyadi 085216155289
082165546657

Dibuat oleh Kontraktor,

PT PRAKARSA ENVIRO INDONESIA

SLAMET ARYADI
ADMINISTRASI
Inspeksi Alat Kerja Tangan
 Inspeksi

Foto : Pemeriksaan Alat Kerja Tangan

Bor Tangan Gerinda Tangan

Prosedur (TKO/TKI)
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Material Safety Data Sheet
Conforms to Regulation (EC) No. 1907/2006 (REACH), Annex II - Europe

SAFETY DATA SHEET

LEWATIT MonoPlus S 108
56698357
1. IDENTIFICATION OF THE SUBSTANCE/PREPARATION
AND OF THE COMPANY/UNDERTAKING
Identification of the substance or preparation
Product name : LEWATIT MonoPlus S 108
Use of the : Ion exchange, resins and catalysts
substance/preparation
Supplier/Manufacturer : LANXESS Deutschland GmbH, Industrial & Environmental Affairs
51369 Leverkusen, Germany, Telephone: +49 214 30 65109
E-mail: infosds@lanxess.com
Emergency telephone number : +49 214 30 99300 (Sicherheitszentrale CHEMPARK Leverkusen)

2. HAZARDS IDENTIFICATION
The product is not classified as dangerous according to Directive 1999/45/EC and its amendments.
See section 11 for more detailed information on health effects and symptoms.

3. COMPOSITION/INFORMATION ON INGREDIENTS
Yes.

Product definition (REACH) : Preparation

styrene-divinylbenzene-copolymer with sulphonic acid groups in
sodium form
CAS number : 566-983-57

Within the present knowledge of the supplier, this product does not contain any hazardous
ingredients in quantities requiring reporting in this section, in accordance with EU or national
regulations.

4. FIRST AID MEASURES

First-aid measures
Inhalation : Move exposed person to fresh air. Keep person warm and at rest.
If not breathing, if breathing is irregular or if respiratory arrest
occurs, provide artificial respiration or oxygen by trained personnel.
Get medical attention if symptoms occur. If unconscious, place in
recovery position and get medical attention immediately. Maintain
an open airway. Loosen tight clothing such as a collar, tie, belt or
waistband.
Ingestion : Wash out mouth with water. Move exposed person to fresh air.
Keep person warm and at rest. If material has been swallowed and
the exposed person is conscious, give small quantities of water to
drink. Stop if the exposed person feels sick as vomiting may be
dangerous. Do not induce vomiting unless directed to do so by
medical personnel. If vomiting occurs, the head should be kept low
so that vomit does not enter the lungs. Get medical attention if
symptoms occur. Never give anything by mouth to an unconscious
person. If unconscious, place in recovery position and get medical
Date of issue : 2009-09-03 Page: 1/6
LEWATIT MonoPlus S 108 56698357 / 1

attention immediately. Maintain an open airway. Loosen tight

clothing such as a collar, tie, belt or waistband.
Skin contact : Flush contaminated skin with plenty of water. Remove
contaminated clothing and shoes. Get medical attention if
symptoms occur. Wash clothing before reuse. Clean shoes
thoroughly before reuse.
Eye contact : Immediately flush eyes with plenty of water, occasionally lifting the
upper and lower eyelids. Check for and remove any contact lenses.
Continue to rinse for at least 10 minutes. Get medical attention if
irritation occurs.
See section 11 for more detailed information on health effects and symptoms.

5. FIRE-FIGHTING MEASURES
Extinguishing media
Suitable
Not suitable
Special exposure hazards
Hazardous combustion
products
Special protective
equipment for fire-fighters
: In case of fire, use water spray (fog), foam, dry chemical or CO2.
: None known.
: No specific fire or explosion hazard.
Promptly isolate the scene by removing all persons from the vicinity
of the incident if there is a fire. No action shall be taken involving
any personal risk or without suitable training.
: No specific data.
: Fire-fighters should wear appropriate protective equipment and self-
contained breathing apparatus (SCBA) with a full face-piece
operated in positive pressure mode.

6. ACCIDENTAL RELEASE MEASURES

Personal precautions : No action shall be taken involving any personal risk or without
suitable training. Keep unnecessary and unprotected personnel
from entering. Provide adequate ventilation. Put on appropriate
personal protective equipment (see section 8). Hazard of slipping on
spilt product.
Environmental precautions : Avoid dispersal of spilt material and runoff and contact with soil,
waterways, drains and sewers. Inform the relevant authorities if the
product has caused environmental pollution (sewers, waterways, soil
or air).
Large spill : Move containers from spill area. Prevent entry into sewers, water
courses, basements or confined areas. Vacuum or sweep up
material and place in a designated, labelled waste container.
Dispose of via a licensed waste disposal contractor. Note: see
section 1 for emergency contact information and section 13 for
waste disposal.
Small spill : Move containers from spill area. Vacuum or sweep up material and
place in a designated, labelled waste container. Dispose of via a
licensed waste disposal contractor.

Date of issue : 2009-09-03 Page: 2/6

LEWATIT MonoPlus S 108 56698357 / 1

7. HANDLING AND STORAGE

Handling : Put on appropriate personal protective equipment (see section 8).
Eating, drinking and smoking should be prohibited in areas where
this material is handled, stored and processed. Workers should
wash hands and face before eating, drinking and smoking. Do not
ingest. Avoid contact with eyes, skin and clothing. Keep in the
original container or an approved alternative made from a
compatible material, kept tightly closed when not in use. Empty
containers retain product residue and can be hazardous.
Storage : Store between the following temperatures: -20 to 40°C (-4 to
104°F). Store in accordance with local regulations. Store in original
container protected from direct sunlight in a dry, cool and well-
ventilated area, away from incompatible materials (see section 10)
and food and drink. Keep container tightly closed and sealed until
ready for use. Containers that have been opened must be carefully
resealed and kept upright to prevent leakage. Do not store in
unlabelled containers. Use appropriate containment to avoid
environmental contamination.
Packaging materials
Recommended : Use original container.
Remarks : Take precautionary measures against electrostatic discharges. Do
not allow to dry out.

8. EXPOSURE CONTROLS/PERSONAL PROTECTION

Exposure limit values : Not available.

Recommended monitoring : If this product contains ingredients with exposure limits, personal,
procedures workplace atmosphere or biological monitoring may be required to
determine the effectiveness of the ventilation or other control
measures and/or the necessity to use respiratory protective
equipment. Reference should be made to European Standard EN
689 for methods for the assessment of exposure by inhalation to
chemical agents and national guidance documents for methods for
the determination of hazardous substances.
Risk management measures
Occupational exposure controls
Technical measures : If this product contains ingredients with exposure limits, use process
enclosures, local exhaust ventilation or other engineering controls to
keep worker exposure below any recommended or statutory limits.
Personal protection measures
Respiratory protection : Use a properly fitted, air-purifying or air-fed respirator complying
with an approved standard if a risk assessment indicates this is
necessary. Respirator selection must be based on known or
anticipated exposure levels, the hazards of the product and the safe
working limits of the selected respirator.

Date of issue : 2009-09-03 Page: 3/6

LEWATIT MonoPlus S 108 56698357 / 1

Hand protection : Chemical-resistant, impervious gloves complying with an approved

standard should be worn at all times when handling chemical
products if a risk assessment indicates this is necessary. After
contamination with product change the gloves immediately and
dispose of them according to relevant national and local regulations
<1 hours (breakthrough time): Polyvinyl chloride - PVC , Nitrile
rubber - NBR , Polychloroprene - CR
Eye protection : Safety eyewear complying with an approved standard should be
used when a risk assessment indicates this is necessary to avoid
exposure to liquid splashes, mists, gases or dusts.
Recommended: safety glasses with side-shields

Skin protection : Personal protective equipment for the body should be selected
based on the task being performed and the risks involved and
should be approved by a specialist before handling this product.

Hygiene measures
: Wash hands, forearms and face thoroughly after handling chemical
products, before eating, smoking and using the lavatory and at the
end of the working period. Appropriate techniques should be used
to remove potentially contaminated clothing. Wash contaminated
clothing before reusing. Ensure that eyewash stations and safety
showers are close to the workstation location.

Environmental exposure controls

Technical measures : Emissions from ventilation or work process equipment should be
checked to ensure they comply with the requirements of
environmental protection legislation. In some cases, fume
scrubbers, filters or engineering modifications to the process
equipment will be necessary to reduce emissions to acceptable
levels.

9. PHYSICAL AND CHEMICAL PROPERTIES

General information
Appearance
Physical state : Solid. [beads]
Colour : Black.
Important health, safety and environmental information
pH : 8 [Conc. (% w/w): 10%]
Bulk density : 800 kg/m3
Solubility : Insoluble in the following materials: cold water
Combustibility at 20 °C : BZ 1 = no ignition (VDI 2263).

10. STABILITY AND REACTIVITY

Stability : The product is stable.
Possibility of hazardous : Under normal conditions of storage and use, hazardous reactions
reactions will not occur.
Conditions to avoid : Separate from oxidizing materials. Take precautionary measures
against static discharges.
Hazardous decomposition : Under normal conditions of storage and use, hazardous
products decomposition products should not be produced.

Date of issue : 2009-09-03 Page: 4/6

LEWATIT MonoPlus S 108 56698357 / 1

11. TOXICOLOGICAL INFORMATION

Acute toxicity

Product/ingredient Result Species Dose Exposure Test

name
LEWATIT MonoPlus S LD50 * Rat >5000 - -
108 Oral mg/kg
*Test results on an analogous product
Irritation/Corrosion
Skin : Non-irritating *Test results on an analogous product
Eyes : Non-irritating *Test results on an analogous product

12. ECOLOGICAL INFORMATION

Remarks : The product is insoluble in water. Therefore, ecological tests have

not been conducted.
Not available.

13. DISPOSAL CONSIDERATIONS

Methods of disposal
Hazardous waste
: Examine possibilities for re-utilisation. Product residues and
uncleaned empty containers should be packaged, sealed, labelled,
and disposed of or recycled according to relevant national and local
regulations. Where large quantities are concerned, consult the
supplier. When uncleaned empty containers are passed on, the
recipient must be warned of any possible hazard that may be
caused by residues. For disposal within the EC, the appropriate
code according to the European Waste List (EWL) should be used.
It is among the tasks of the polluter to assign the waste to waste
codes specific to industrial sectors and processes according to the
European Waste List (EWL).
: Within the present knowledge of the supplier, this product is not
regarded as hazardous waste, as defined by EU Directive
91/689/EEC.

14. TRANSPORT INFORMATION

Regulation UN Proper shipping name Class PG Label Additional
number information
ADR/RID - - - - - Not regulated.

GGVSE - - - - - Not regulated.

ADNR - - - - - Not regulated.

Date of issue : 2009-09-03 Page: 5/6

LEWATIT MonoPlus S 108 56698357 / 1

Regulation UN Proper shipping name Class PG Label Additional

number information
IMDG - - - - - Not regulated.

IATA - - - - - Not regulated.

PG: Packing group

Not dangerous cargo.

Avoid heat above +40 °C.
Avoid temperatures below -20 °C.
Has a slight odour.
Keep separated from foodstuffs.

15. REGULATORY INFORMATION

EU regulations
Classification and labeling have been determined according to EU Directives 67/548/EEC and
1999/45/EC (including amendments) and take into account the intended product use.
Industrial applications.
Risk phrases : This product is not classified according to EU legislation.

16. OTHER INFORMATION

History
Date of printing : 2009-09-03
Date of issue : 2009-09-03
Date of previous issue : No previous validation
Version : 1
Indicates information that has changed from previously issued version.
Notice to reader
The data given here is based on current knowledge and experience. The purpose of this
Safety Data Sheet is to describe the products in terms of their safety requirements. The above
details do not imply any guarantee concerning composition, properties or performance.

Date of issue : 2009-09-03 Page: 6/6

Conforms to Regulation (EC) No. 1907/2006 (REACH), Annex II - Europe

SAFETY DATA SHEET

LEWATIT MonoPlus M 500
05274923
1. IDENTIFICATION OF THE SUBSTANCE/PREPARATION
AND OF THE COMPANY/UNDERTAKING
Identification of the substance or preparation
Product name : LEWATIT MonoPlus M 500
Use of the : Ion exchange, resins and catalysts
substance/preparation
Supplier/Manufacturer : LANXESS Deutschland GmbH, Industrial & Environmental Affairs
51369 Leverkusen, Germany, Telephone: +49 214 30 65109
E-mail: infosds@lanxess.com
Emergency telephone number : +49 214 30 99300 (Sicherheitszentrale CHEMPARK Leverkusen)

2. HAZARDS IDENTIFICATION
The preparation is not classified as dangerous according to Directive 1999/45/EC and its amendments.
See section 11 for more detailed information on health effects and symptoms.

3. COMPOSITION/INFORMATION ON INGREDIENTS
Yes.

Product definition (REACH) : Preparation

styrene-divinylbenzene-copolymer with trialkyl ammonium groups in
chloride form
CAS Number : 0527-49-23

Within the present knowledge of the supplier, this product does not contain any hazardous
ingredients in quantities requiring reporting in this section, in accordance with EU or
national regulations.

4. FIRST AID MEASURES

First-aid measures
Inhalation : Move exposed person to fresh air. Keep person warm and at rest.
If not breathing, if breathing is irregular or if respiratory arrest
occurs, provide artificial respiration or oxygen by trained personnel.
Obtain medical attention if symptoms occur. If unconscious, place
in recovery position and get medical attention immediately. Maintain
an open airway. Loosen tight clothing such as a collar, tie, belt or
waistband. In case of inhalation of decomposition products in a fire,
symptoms may be delayed. The exposed person may need to be
kept under medical surveillance for 48 hours.
Ingestion : Wash out mouth with water. Move exposed person to fresh air.
Keep person warm and at rest. If material has been swallowed and
the exposed person is conscious, give small quantities of water to
drink. Stop if the exposed person feels sick as vomiting may be
dangerous. Do not induce vomiting unless directed to do so by
medical personnel. If vomiting occurs, the head should be kept low
so that vomit does not enter the lungs. Obtain medical attention if
symptoms occur. Never give anything by mouth to an unconscious
person. If unconscious, place in recovery position and get medical
attention immediately. Maintain an open airway. Loosen tight
Date of issue : 2008-07-17 Page: 1/6
LEWATIT MonoPlus M 500 05274923 / 3

clothing such as a collar, tie, belt or waistband.

Skin contact : Flush contaminated skin with plenty of water. Remove
contaminated clothing and shoes. Obtain medical attention if
symptoms occur. Wash clothing before reuse. Clean shoes
thoroughly before reuse.
Eye contact : Immediately flush eyes with plenty of water, occasionally lifting the
upper and lower eyelids. Check for and remove any contact lenses.
Continue to rinse for at least 10 minutes. Get medical attention if
irritation occurs.
See section 11 for more detailed information on health effects and symptoms.

5. FIRE-FIGHTING MEASURES
Extinguishing media
Suitable
Not suitable
Special exposure hazards
Hazardous combustion
products
Special protective
equipment for fire-fighters
: In case of fire, use water spray (fog), foam, dry chemical or CO2.
: None known.
: No specific fire or explosion hazard.
Promptly isolate the scene by removing all persons from the vicinity
of the incident if there is a fire. No action shall be taken involving
any personal risk or without suitable training.
: Decomposition products may include the following materials:
carbon oxides
nitrogen oxides
: Fire-fighters should wear appropriate protective equipment and self-
contained breathing apparatus (SCBA) with a full face-piece
operated in positive pressure mode.

6. ACCIDENTAL RELEASE MEASURES

Personal precautions
Environmental precautions
Large spill
Small spill
: No action shall be taken involving any personal risk or without
suitable training. Keep unnecessary and unprotected personnel from
entering. Provide adequate ventilation. Put on appropriate personal
protective equipment (see section 8). Hazard of slipping on spilt
product.
: Avoid dispersal of spilt material and runoff and contact with soil,
waterways, drains and sewers. Inform the relevant authorities if the
product has caused environmental pollution (sewers, waterways, soil
or air).
: Move containers from spill area. Prevent entry into sewers, water
courses, basements or confined areas. Vacuum or sweep up
material and place in a designated, labelled waste container.
Dispose of via a licensed waste disposal contractor. Note: see
section 1 for emergency contact information and section 13 for waste
disposal.
: Move containers from spill area. Vacuum or sweep up material and
place in a designated, labelled waste container. Dispose of via a
licensed waste disposal contractor.

Date of issue : 2008-07-17 Page: 2/6

LEWATIT MonoPlus M 500 05274923 / 3

7. HANDLING AND STORAGE

Handling : Put on appropriate personal protective equipment (see section 8).
Eating, drinking and smoking should be prohibited in areas where
this material is handled, stored and processed. Workers should
wash hands and face before eating, drinking and smoking. Do not
ingest. Avoid contact with eyes, skin and clothing. Keep in the
original container or an approved alternative made from a
compatible material, kept tightly closed when not in use. Empty
containers retain product residue and can be hazardous.
Storage : Store between the following temperatures: -20 to 40°C (-4 to 104°F).
Store in accordance with local regulations. Store in original
container protected from direct sunlight in a dry, cool and well-
ventilated area, away from incompatible materials (see section 10)
and food and drink. Keep container tightly closed and sealed until
ready for use. Containers that have been opened must be carefully
resealed and kept upright to prevent leakage. Do not store in
unlabelled containers. Use appropriate containment to avoid
environmental contamination.
Packaging materials
Recommended : Use original container.
Remarks : Take precautionary measures against electrostatic discharges. Do
not allow to dry out.

8. EXPOSURE CONTROLS/PERSONAL PROTECTION

Exposure limit values : Not available.

Recommended monitoring : If this product contains ingredients with exposure limits, personal,
procedures workplace atmosphere or biological monitoring may be required to
determine the effectiveness of the ventilation or other control
measures and/or the necessity to use respiratory protective
equipment. Reference should be made to European Standard EN
689 for methods for the assessment of exposure by inhalation to
chemical agents and national guidance documents for methods for
the determination of hazardous substances.
Risk management measures
Occupational exposure controls
Technical measures : No special ventilation requirements. Good general ventilation
should be sufficient to control worker exposure to airborne
contaminants. If this product contains ingredients with exposure
limits, use process enclosures, local exhaust ventilation or other
engineering controls to keep worker exposure below any
recommended or statutory limits.
Personal protection measures
Respiratory protection : Use a properly fitted, air-purifying or air-fed respirator complying with
an approved standard if a risk assessment indicates this is
necessary. Respirator selection must be based on known or
anticipated exposure levels, the hazards of the product and the safe
working limits of the selected respirator.

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Hand protection : Chemical-resistant, impervious gloves complying with an approved

standard should be worn at all times when handling chemical
products if a risk assessment indicates this is necessary. After
contamination with product change the gloves immediately and
dispose of them according to relevant national and local regulations
<1 hours (breakthrough time): PVC , nitrile rubber , Polychloroprene
- CR
Eye protection : Safety eyewear complying with an approved standard should be
used when a risk assessment indicates this is necessary to avoid
exposure to liquid splashes, mists, gases or dusts.
Recommended: safety glasses with side-shields
Skin protection : Personal protective equipment for the body should be selected
based on the task being performed and the risks involved and
should be approved by a specialist before handling this product.
Hygiene measures : Wash hands, forearms and face thoroughly after handling chemical
products, before eating, smoking and using the lavatory and at the
end of the working period. Appropriate techniques should be used
to remove potentially contaminated clothing. Wash contaminated
clothing before reusing. Ensure that eyewash stations and safety
showers are close to the workstation location.
Environmental exposure controls
Technical measures : Emissions from ventilation or work process equipment should be
checked to ensure they comply with the requirements of
environmental protection legislation. In some cases, fume
scrubbers, filters or engineering modifications to the process
equipment will be necessary to reduce emissions to acceptable
levels.

9. PHYSICAL AND CHEMICAL PROPERTIES

General information
Appearance
Physical state : Solid. [beads]
Colour : Yellow.
Odour : Amine-like.
Important health, safety and environmental information
pH : <9 [Conc. (% w/w): 10%]
Density : 1.08 kg/L (20 °C)
Bulk density: : 690 kg/m3
Solubility : Insoluble in the following materials: cold water
Ignition temperature: : >250°C

10. STABILITY AND REACTIVITY

Stability : The product is stable.
Conditions to avoid : Segregate from oxidising materials. Take precautionary measures
against static discharges.
Hazardous decomposition : Under normal conditions of storage and use, hazardous
products decomposition products should not be produced.

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11. TOXICOLOGICAL INFORMATION

Potential acute health effects
Acute toxicity

Product/ingredient Result Species Dose Exposure Test

name
LEWATIT MonoPlus M LD50 * Rat >2000 mg/kg - -
500 Oral
*Test results on an analogous product
Irritation/Corrosion
Skin : Non-irritating . Test results on an analogous product .
Eyes : Non-irritating . Test results on an analogous product .

12. ECOLOGICAL INFORMATION

Remarks : Because of the insolubility of the substance in water there are no
data available on its toxicity in the aqueous environment.
Not available.

13. DISPOSAL CONSIDERATIONS

Methods of disposal
Hazardous waste
: Examine possibilities for re-utilisation. Product residues and
uncleaned empty containers should be packaged, sealed, labelled,
and disposed of or recycled according to relevant national and local
regulations. Where large quantities are concerned, consult the
supplier. When uncleaned empty containers are passed on, the
recipient must be warned of any possible hazard that may be
caused by residues. For disposal within the EC, the appropriate
code according to the European Waste List (EWL) should be used.
It is among the tasks of the polluter to assign the waste to waste
codes specific to industrial sectors and processes according to the
European Waste List (EWL).
: Within the present knowledge of the supplier, this product is not
regarded as hazardous waste, as defined by EU Directive
91/689/EEC.

14. TRANSPORT INFORMATION

Regulation UN Proper shipping name Class PG Label Additional
number information
ADR/RID - - - - - Not regulated.

GGVSE - - - - - Not regulated.

ADNR - - - - - Not regulated.

IMDG - - - - - Not regulated.

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Regulation UN Proper shipping name Class PG Label Additional

number information
IATA - - - - - Not regulated.

PG: Packing group

Not dangerous cargo.

Avoid temperatures below -20 °C.
Keep separated from foodstuffs.

15. REGULATORY INFORMATION

EU regulations
Classification and labeling have been determined according to EU Directives 67/548/EEC and
1999/45/EC (including amendments) and take into account the intended product use.
Industrial applications.
Risk phrases : This product is not classified according to EU legislation.

16. OTHER INFORMATION

History
Date of printing : 2008-07-17
Date of issue : 2008-07-17
Date of previous issue : 2007-03-09
Version : 3
Notice to reader
The data given here is based on current knowledge and experience. The purpose of this Safety
Data Sheet is to describe the products in terms of their safety requirements. The above details
do not imply any guarantee concerning composition, properties or performance.

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