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California Hazardous Materials Inventory Reporting Form -Themical Description Page <br /> (I) ADD DELETE REVISE 1997 PAGE(2) [-E OF(3) <br /> BUSINESS NAME (4) <br /> Dentoni's Custom Truck Works <br /> CHEMICAL LOCATION(S)(5) <br /> <br /> =� .•::.r,7Ell <br /> " VICE <br /> CHEMICAL NAME (8) Carbon Dioxide TRADE SECRET(1 1) ❑Y jjj N <br /> COMMON NAME (9) Carbonic Anhydride *EHS (12) 1 ❑Y iEN <br /> *IF EHS BOX IS "Y" <br /> CAS # (10) 123-38-9 ALL AMOUNTS MUST BE IN LRS <br /> FIRE CODE (13) <br /> HAZARD <br /> CATEGORIES <br /> TYPE (14) x3PURE ❑MLXTURE ❑WASTE RADIOACTIVE(15) ❑Y ® N (16)(� <br /> PHYSICAL STATE(17) ❑SOLID ❑LIQUID ❑X GAS CURIES J <br /> FED HAZARD <br /> CATEGORIES (18) 1:1PIRE ❑REACTIVE E]PRFSSLRE RELEASE ❑ACGTE HEALTH ❑CHROMC HEALTH <br /> -- <br /> STATE WASTE (19) UNITS* (22) []GAL g❑ CU FT MAX DAILY AMT(23) 175 'r <br /> CODE []LBS ❑ TONS <br /> DAYS ON SITE (20) AVG DAILY AT(24)�� <br /> 365 *If EHS, amounts must be in lbs -350 <br /> LARGEST (2I - ANNUAL WASTE AMT(25) <br /> CONTAINER get COIeto CA- <br /> STORAGE (26) ❑ ABOVE GROUND TANK ❑ CAN ❑ BOX ❑TANK WAGON <br /> CONTAINER F_1 TANK []CARBOY ® CYLINDER ❑RAIL CAR <br /> ❑TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE ❑-------------------- <br /> ❑STEEL DRUM ❑ FIBER DRUM ❑ PLASTIC BOTTLE <br /> ❑ PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN <br /> STORAGE (27) ® AMBIENT ❑ABOVE AMBIENT []BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) ©AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑ CRYOGENIC <br /> TEMPERATURE <br /> 29 %WT 30 HAZARDOUS COMPONENT (3 1)EHS 32 CAS# <br /> Y N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION(33): DOT# <br /> For Official Use Only: ❑ C ❑ R ❑ S SJC 12/96 <br />