HAND SANITIZER- hand sanitizer foam bac aerosol, foam 
Atlanta Supersource, Inc.

Disclaimer: Most OTC drugs are not reviewed and approved by FDA, however they may be marketed if they comply with applicable regulations and policies. FDA has not evaluated whether this product complies.

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SS Hand Sanitizer Foam - BAC

Hand Sanitizer Foam BAC

Product Description: Non-Flammable, Non-Toxic Hand Sanitizer for everyday use. Will not dry hands. Reduces Common Harmful Germs and Bacteris. FDA approved formulation, manufactured in an FDA Registered Facility. For use when soap and water is not always available.

NDC: 75056-006-01

Atlanta Supersource, Inc.

3655 Kennesaw 75 Parkway

Suite 100

Kennesaw, Georgia 30144

EMERGENCY RESPONSE PROVIDED BY: Chemtrec 1.800.424.9300

Item Number: CLE219

Proudly Made in the USA

Manufactured in an FDA Registered Facility

Active Ingredient (s)

Benzalkonium Chloride 0.1%

Purpose

Antimicrobial

Uses

Hand Sanitizer to help reduce bacteria that can potntially cause disease. For use when soap and water are not available. Recommended for repeated use.

Warnings

For external use only.

When using this product

keep out of eyes, ears, and mouth. In case of contact with eyes, rinse eyes thouroughly with water.

Stop use and ask doctor

if irritation or rash occurs.

Keep out of reach of children

Keep out of reach of children. If swallowed, get medical help or contact a Poison Control Center right away.

Directions

Place enough product on hands to cover all surfaces. Rub hands together until dry. Supervise children under 6 years of age when using this product to avoid swallowing.

Inactive Ingredients

Water, Laurtrimonium Chloride, Cetrimonium Chloride, Dihydroxyethyl Cocamine Oxide

Glycereth-17 Cocoate, Citric Acid Monohydrate - these are not on the Product Data Sheet and Katie explained they do not need to be listed.

Questions or Comments?

Call us at 833.423.0006

Supersource Instant Hand Sanitizer Rinse-Free Foam

Net Contents: 1 Gallon (3.78L) 1 gallon label

HAND SANITIZER 
hand sanitizer foam bac aerosol, foam
Product Information
Product TypeHUMAN OTC DRUGItem Code (Source)NDC:75056-006
Route of AdministrationTOPICAL
Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
BENZALKONIUM CHLORIDE (UNII: F5UM2KM3W7) (BENZALKONIUM - UNII:7N6JUD5X6Y) BENZALKONIUM CHLORIDE0.1 g  in 100 g
Inactive Ingredients
Ingredient NameStrength
DIHYDROXYETHYL COCAMINE OXIDE (UNII: 8AR51R3BL5) 0.0099 g  in 100 g
CETRIMONIUM CHLORIDE (UNII: UC9PE95IBP) 0.0099 g  in 100 g
WATER (UNII: 059QF0KO0R) 99.8703 g  in 100 g
LAURTRIMONIUM CHLORIDE (UNII: A81MSI0FIC) 0.0099 g  in 100 g
Packaging
#Item CodePackage DescriptionMarketing Start DateMarketing End Date
1NDC:75056-006-013785 g in 1 BOTTLE, PLASTIC; Type 0: Not a Combination Product07/20/2020
Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
OTC monograph not finalpart333A07/20/2020
Labeler - Atlanta Supersource, Inc. (806786778)
Establishment
NameAddressID/FEIBusiness Operations
Atlanta Supersource, Inc.806786778manufacture(75056-006)

Revised: 12/2022
Document Id: ef199777-e52d-f9e7-e053-2995a90a76ed
Set id: aaa831ca-c231-5a47-e053-2a95a90ab862
Version: 3
Effective Time: 20221205
 
Atlanta Supersource, Inc.