Health & Safety Division

Users Guide to Completing the
Online Hazardous Substance Survey Form (HSSF)

First- Time Users


    Enter site and create an account by entering the following required information:
    • USER NAME – six characters
    • FEDERAL ID NUMBER – actual FEIN for your workplace (enter 2 digits – then, 7 digits)
    • COMPANY ACCESS CODE – six characters

      Note: If you are the first person to set up an account, your access code will be the default code required to create additional user accounts for your workplace (FEIN).
    • PASSWORD – six characters
    • EMAIL ADDRESS – for the person who should receive notifications from the Health & Safety Division about your online survey form.
    When you have successfully created your account, an email will be sent from the Health & Safety Division letting you know that you are now registered as a user.

    Enter workplace identification information (Items 1 – 12)

    List Product(s) and Chemical Ingredients
    1. Workplace Identification Information

      Enter the required workplace identification information, Items 1 – 12, on the form. If any information is incorrectly entered or incomplete, you will receive a message indicating what must be updated to proceed with completing the survey. When this information is entered correctly, you can then begin to add products and specific chemical ingredients to your survey form. Click ADD A PRODUCT at the bottom of the screen.
    2. Adding Products / Chemical Ingredients

      Enter the name of the product as it appears on your Material Safety Data Sheet (MSDS)/Safety Data Sheet (SDS) and click ADD PRODUCT.

      Next, enter the chemical abstract service (CAS) number in the three appropriate fields for the chemical ingredient(s) found on the MSDS/SDS and click CHECK. If it is a regulated chemical that needs to be listed on the survey, it will match a number on the Chemical Abstract List and automatically be added to the form. Click ADD CHEMICAL whenever there is a match from the Chemical Abstract List and the ingredient will be added to your survey form.

      If it is a chemical that is not regulated by PA, you will see a message that there is no match. Enter the next CAS# and continue checking the other chemical ingredient(s) for the product.

      When you have checked all the chemical ingredients for the product, click SUBMIT PRODUCT.

      Note: If the chemical ingredient name on your MSDS/SDS differs from the chemical name on the Chemical Abstract List (CAS# will be the same) you can use the Comments section on the form to list the name as it appears exactly on the MSDS/SDS.

      If you do not have the CAS# for an ingredient, open the Chemical Abstract List window and check the list (alphabetical for the chemical name). If you find the chemical name on the list, enter the PA-ID number that has been assigned to that chemical. Enter the PA-ID number (PA001-00-0) the same way you enter the CAS# (use all three fields).

      Note: PA-ID numbers (PA001-00-0 through PA188-00-0) are only for use with the Online HSSF.

    You can edit and delete information on your survey several different ways. The workplace identification information can be edited. Products can be deleted. Specific chemical ingredients within a product can be edited and/or deleted. Edits and deletes can be done while you are working on the survey, when you VIEW survey and/or when you have already submitted your survey and have logged back on to work on an existing survey. Simply click EDIT or DEL to make your changes. Remember to click SUBMIT SURVEY when you have finished editing or deleting to save the new changes.

    VIEW SURVEY allows you to see all the information that you’ve entered. You can edit and delete information in the view survey screen.

    When you click SUBMIT SURVEY, you are saving the information that you have entered to this point. If you do not click submit survey, the data that you entered will not be saved to your hazardous substance survey form. Click SUBMIT SURVEY any time you finish your work session with the online HSSF.

    You will receive email notifications about your account and survey form from the Health & Safety Division. These notifications will go to the email address that you entered when you registered for an account. The first email you will receive is notification that your account has been successfully created. It will contain a reminder about your access code and password. When you complete the workplace identification information online, you will receive a second email notification indicating that your survey has been created. The email will contain a form ID number for future reference. Once your survey is created, anytime you logon and modify an existing survey, you will receive an email from the Health & Safety Division. If there is a problem with your online survey you will also receive an email from the Health & Safety Division with a customized message about the specific problem with the survey and a message to resubmit.

Repeat Users


    Enter the same required information that you used to initially create your account. This information was sent to you with the initial email notification from the Health & Safety Division.

    After you have successfully logged on, proceed to edit and/or delete items on your existing survey(s).

    You can also create a new survey form for a particular FEIN. Identify the specific workplace information for the new form (Items 1 – 12). For example, a school district has a specific FEIN for the district but may have four or more workplaces: high school, middle school, elementary school, and administrative offices. A survey can be created for each of the four separate work locations and would all be under the same account FEIN. However, each workplace survey form will have its own separate ID form number assigned by the Health & Safety Division.

    Reminder: A HSSF must be posted in all public sector workplaces. Once you have created an online HSSF you can print a copy that you will sign and date for posting purposes. Specific instructions for printing your survey are provided when you exit the application.
  5. HELP

    Open the HELP window for explanations on specific items when you are working on your survey, if needed. If you require additional instructions or further assistance, contact the Health & Safety Division at 717-772-1635.
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