1.1 (Form 1.1)

1종화학물질의 연간신고 (Annual Declaration of Schedule 1 Chemical) : 전년도 동안 단일소규모시설 뿐만 아니라 기타시설의 사항 (Information for each Schedule 1 Chemical at the SSSF as well as at Other Schedule 1 Facilities during the Previous Year)

(단일소규모시설 뿐만 아니라 기타시설에서 생산, 소비 또는 저장된 1종화학물질에 대하여 작성하시오.) (Please complete one form for each Schedule 1 chemical that was produced, comsumed or stored at the SSSF as well as other Schedule 1 facilities.)

□ 시설코드(Facility Code) :

/. IUPAC 화학명(IUPAC chemical name) :

/. 만약 화학물질 핸드북에 포함되어 있지 않다면, 구조식을 작성하시오(Identify the attachment for structural formula, if not contained in the handbook for chemicals) :

/. CAS 등록번호(CAS registry number) :

□ 시설에서 생산, 소비 또는 저장된 1종화학물질의 총량 (Total amounts of the Schedule 1 chemical produced, consumed or stored at the facility)

/. 생산량(Quantity Produced) :

/. 생산방법(Production methods employed) :

(단일소규모시설과 □보호목적의 기타시설□에만 해당됨.) (required only for the SSSF and the "other facility for protective purpose")

/. 소비량(Quantity consumed) :

/. 소비목적(Purpose of consumption(Use C01 to C06 of codes or specify)) :

연구 (Research)(C01)	□	의료 (Medical)(C02)	□
의약 (Pharmaceutical)(C03)	□	보호 (Protective)(C04)	□
폐기물처리 (Waste disposal)(C05)	□
기타 1종화학물질의 생산 (Production of other Schedule 1 chemicals)(C06)			□

/. 자국의 기타시설로부터 인수된 총량(단일소규모시설에만 요구됨)(Total quantity received from other facilities in the State Party(required only for SSSF)) :

/. 자국의 기타시설에 공급된 1종화학물질의 총량(Total quantity of the Schedule 1 chemical supplied to other facilities in the State Party) :

/. 전년도 중 1종화학물질의 저장된 최대량(Maximum quantity of the Schedule 1 chemical stored at any time during the previous year) :

/. 전년도 종료시 1종화학물질의 저장량(Quantity of the Schedule 1 chemical stored at the end of the previous year) :