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Material Safety Data Sheet
PERMANONE 31-66
SECTION 1. CHEMICAL PRODUCT AND COMPANY INFORMATION
Product Name
Chemical Name
Synonym
MSDS Number

Chemical Family
Chemical Formulation
EPA Registration No.
Canadian Registrat. No.
Aventis95 Chestnut Ridge RoadMontvale, NJ 07645USA ! For Product Use Information: (800)331-2867 Monday through Friday 8:00AM-4:30PM For Medical Emergency contact DART: (800) 334-7577 24 Hours/Day For Transportation Emergency CHEMTREC: (800) 424-9300 24 Hours/Day SECTION 2. COMPOSITION/INFORMATION ON INGREDIENTS
Component Name
Concentration % by Weight
SECTION 3. HAZARDS IDENTIFICATION
NOTE: Please refer to Section 11 for detailed toxicological information. Emergency Overview
Health: Harmful if swallowed, absorbed through skin or inhaled. Prolonged orfrequently repeated skin contact may cause allergic reactions in someindividuals. Avoid contact with skin, eyes or clothing. Avoid breathing vapors.
Wash thoroughly with soap and water after handling.
Environmental: This product is extremely toxic to fish and aquatic invertebratesand highly toxic to bees.
Physical State
Appearance
Routes of Exposure
Ingestion, inhalation, and skin contact.
Immediate Effects
Material Safety Data Sheet
PERMANONE 31-66
Harmful if absorbed. Prolonged or frequently repeated skin contact may causeallergic reactions in some individuals. Slightly irritating.
Ingestion
Inhalation
Chronic or Delayed
See Section 11 for carcinogenic/oncogenic information on piperonyl butoxide Long-Term
Medical Conditions
Aggravated by Exposure
SECTION 4. FIRST AID MEASURES
Flush eyes with plenty of water. Get medical attention if irritation persists.
Wash with plenty of soap and water and get medical attention.
Ingestion
Call a physician or Poison Control Center. Drink one or two glasses of water andinduce vomiting by touching back of throat with finger. Do not induce vomiting orgive anything by mouth to an unconscious person.
Inhalation
Remove victim to fresh air. If not breathing, give artificial respiration. Get medicalattention.
Note to Physician
This product contains a pyrethroid. If a small amount is ingested (or if treatmentis delayed) oral administration of large amounts of activated charcoal and acathartic is probably sufficient therapy.
Do not administer milk, cream or other substances containing vegetable oranimal fats, which enhance the absorption of lipophilic substances.
SECTION 5. FIRE FIGHTING MEASURES
Flash Point
Suitable Extinguishing
Carbon dioxide, dry chemical, foam or water.
Fire Fighting
As in any fire, wear self-contained breathing apparatus pressure-demand, Instructions
MSHA/NIOSH approved (or equivalent) and full protective gear.
SECTION 6. ACCIDENTAL RELEASE MEASURES
General and Disposal
Soak up with an absorbent material such as sand, sawdust, earth, fuller's earth,etc.
SECTION 7. HANDLING AND STORAGE
Handling Procedures
Avoid contact with skin, eyes or clothing. Avoid breathing vapors.
Material Safety Data Sheet
PERMANONE 31-66
Storing Procedures
Do not store at temperatures below 40°F (4.5°C). If this material has beenexposed to temperatures below 40°F (4.5°C) there may be precipitation. Checkfor crystalization. If evident, warm to 80°F (26.5°C) and thoroughly mix beforeusing. DO NOT USE OPEN FLAME.
Work/Hygienic
Wash thoroughly with soap and water after handling.
Procedures
Remove contaminated clothing and wash before reuse.
SECTION 8. EXPOSURE CONTROLS/PERSONAL PROTECTION
Eye/Face Protection
Body Protection
Exposure Limits
SECTION 9. PHYSICAL AND CHEMICAL PROPERTIES
Appearance
Physical State
Specific Gravity
Solubility (in water)
SECTION 10. STABILITY AND REACTIVITY
Chemical Stability
Incompatibility
Hazardous
Polymerization
(Conditions to avoid)

SECTION 11. TOXICOLOGICAL INFORMATION
Acute Oral Toxicity
Acute Dermal Toxicity
Acute Inhalation Toxicity
rat 17.56 mg/l for DOT purposes (1.0 hr) Material Safety Data Sheet
PERMANONE 31-66
Skin Irritation
Eye Irritation
rabbit Tox Category III Mildly irritating Sensitization
The above acute toxicity data from Permanone 31% Butacide 66% Manufacturing Concentrate; EPA Reg. No.
432-1150, which contains 31% permethrin and 66% piperonyl butoxide.
Chronic Toxicity
A statistically significant increase in the incidence of lung and liver tumors wasobserved in female mice receiving diets containing 375 and 750 mg/kg/day ofpermethrin technical over 85 weeks.
A statistically significant increase in the number of benign liver tumors appearedin mice fed piperonyl butoxide technical at doses which far exceed anyanticipated daily human intake. Independent and industry toxicological expertswho have reviewed the data agree that the findings of the study do not indicate ahealth risk to human beings.
Assessment Carcinogenicity
Material Safety Data Sheet
PERMANONE 31-66
SECTION 12. ECOLOGICAL INFORMATION
Environmental
This product is extremely toxic to fish and aquatic organisms. For terrestrial Precautions
uses, do not apply directly to water, or to areas where surface water is present,or to intertidal areas below mean high water mark. Do not apply when weatherconditions favor drift from areas treated. Drift or runoff from treated areas may behazardous to aquatic organisms in neighboring areas. Do not contaminate waterby cleaning of equipment or disposal of equipment wash waters. Do not applywhen wind speeds exceed 10 mph.
This product is highly toxic to bees exposed to direct treatment or residuesremaining on the treated areas. Do not apply this product or allow drift whenbees are actively visiting the treatment area. Applications should be timed toprovide maximum possible interval between treatment and the next period of beeactivity.
SECTION 13. DISPOSAL CONSIDERATIONS
General Disposal
Pesticide Disposal: Wastes resulting from use of this product may be disposed of Guidance
on site or at an approved waste disposal facility.
Container Disposal
Triple rinse (or equivalent). Then offer for recycling or reconditioning, or punctureand dispose of in a sanitary landfill, or by other procedures approved by stateand local authorities.
SECTION 14. TRANSPORT INFORMATION
SECTION 15. REGULATORY INFORMATION
US Federal
EPA Registration No.
TSCA list
TSCA 12b export notification
SARA Title III - section 302 - notification and information
SARA Title III - section 313 - toxic chemical release reporting
US States Regulatory
CA Prop65
This product contains a chemical known to the state of California to cause cancer.
This product contains a chemical known to the state of California to cause birth defects or otherreproductive harm.
US State right-to-know ingredients
Material Safety Data Sheet
PERMANONE 31-66
Canadian Regulations
Canadian Registrat. No.
Canadian Domestic Substance List

Environmental
Clean Water Section 307 Priority Pollutants
Safe Drinking Water Act Maximum Contaminant Levels
International Regulations
EU Classification
European Inventory of Existing Commercial Substances (EINECS)
SECTION 16. OTHER INFORMATION
REVISED SECTIONS: MSDS REVISION INDICATOR: New Format PREPARED BY: Regulatory Department PHONE: 800-438-5837 SUPERCEDES MSDS DATED: 05/19/2000 Print Date: 09/25/2001Supersedes MSDS, which is older than: 09/25/2001 This information is provided in good faith but without express or implied warranty. Buyer assumes allresponsibility for safety and use not in accordance with label instructions. The product names are registeredtrademarks of Aventis.

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Attachment 11A Page 1 of 2 RIVERSIDE COUNTY DEPARTMENT OF MENTAL HEALTH ADULT MEDICAL HISTORY SUMMARY Part I – TO BE COMPLETED BY PATIENT OR PATIENT INFORMANT (Please Print) Patient’s Name: _________________ (First) (Middle) (Last) (Maiden) Informant Patient/Relationship: _________________ Current Physician: _________________ (Addr

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T A B L E T S / C H E W A B L E T A B L E T S / O R A L G R A N U L E S Composition Each tablet/sachet contains: Active Ingredient Tablets: Each 10 mg Tablet contains 10.4 mg montelukast sodium, equivalent to 10mg free acid. Chewable Tablets: Each 5 mg chewable tablet contains 5.2 mg montelukast sodium, equivalent to 5 mg free acid. Each 4 mg chewable tablet contains 4.2 mg monteluka

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