Laserfiche WebLink
California Hazardous Materials Inventory Form - Chemical Description <br /> (I) ❑ADD -❑DELETE JKREVISE 2001 <br /> PAGE(2) = OF(3) <br /> IUSINESS NAME (4) RE <br /> , <br /> CHEMICAL LOCATIONnS)(5) o(� 1 _ <br /> MAP#(6)/ GRID#(7) I [J_�-t �d�Se E= EM FS <br /> �� SEKJ <br /> 4? � (( f TRADE SECRET <br /> CHEMICAL NAME (R) (I I) ❑Y �N <br /> 73 Ct n r e <br /> *EHS(12) ❑Y gN <br /> COMMON NAME (9) G <br /> O JAwt`�I Z�l <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) LEAVE BLANK <br /> HAZARD CLASS <br /> TYPE (14)10 PURE 5aMIXTURE ❑WASTE RADIOACTIVE(I5) ❑YKNI <br /> (16)� <br /> PHYSICAL STATE(17)1 ❑SOLID NLIQUID [:]G= CURIES <br /> FED HAZARD <br /> CATEGORIES (18) ❑FIRE E]REACTIVE E]PRESSURE RELEASE TE ACUHEALTH CHRONIC HEALTH <br /> STATE WASTE (19) UNITS* (22) [j4GAL ❑CU FT ILY AMT(23) SCU <br /> CODE [j4 <br /> [:]LBSLBS ❑ ON-SITE <br /> TONS <br /> DAYS ON SITE (20) AVG DAILY AMT(24) <br /> *[f EHS, amounts must be in lbs ON-SITE p�Q <br /> LARGEST (21 ANNUAL WASTE AMT(25) <br /> CONTAINER S <br /> STORAGE (26) ❑ABOVE GROUND TANK ❑ CAN ❑ BOX ❑TANK WAGON <br /> CONTAINER ❑UNDER GROUND TANK ❑CARBOY ❑ CYLINDER ❑RAIL CAR <br /> ❑TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE El-------------------- <br /> [:1 STEEL DRUM ❑FIBER DRUM P-LASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN <br /> STORAGE (27) 0 AMBIENT ❑ABOVE AMBIENT [_]BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) AMBIENT []ABOVEAMBIENT ❑BELOW AMBIENT ❑CRYOGENIC <br /> TEMPERATURE <br /> (29)%WT 30)HAZARDOUS COMPONENT 31 EHS 32 CAS# <br /> ° ❑Y b6/ -Sa- <br /> ❑Y ❑N <br /> E]YE]NII <br /> ❑Y N <br /> ❑Y ❑N <br /> \DDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) G <br /> \(34)WHAT IS MATERIAL <br /> USED FOR? w,:,5 HCT <br /> For Official Use Only: N C R ❑ S SIC 12/00 <br />