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California Hazardous Materials Inventory Form - Chemical Description <br /> (i) ADD DDELETE F-1h"'VISE I <br /> 2005 PAGE(2) OF(3)a <br /> BUSINESS NAME (4) , <br /> INC . RECEI <br /> CHEMICAL LOCATION(S)(5) (� <br /> <br /> <br /> CHEMICAL NAME (8) TRADE SECRET(11) Fl:-]Y N <br /> COMMON NAME (9) *EHS(12) ❑YQPETkazoa1n N <br /> (iAs <br /> Qp *IF EHS BOX IS"Y" <br /> CAS # (10) 7L} _ /O _ 6 ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) <br /> HAZARD CLASS <br /> TYPE (14) ❑PURE MIXTURE ❑WASTE RADIOACTIVE(15) ❑ Y N (16) NQ <br /> PHYSICAL STATE(17) [-]SOLID ❑LIQUID GAS CURIES <br /> FED HAZARD <br /> CATEGORIES (18) FIRE ❑REACTIVE PRESSURE RELEASE ACUTE HEALTH ❑ CHROMCFEALTH <br /> STATE WASTE (19) A' h UNITS*(22) GAL ❑CU FT MAXILY AMT(23) <br /> CODE <br /> DAYS ON SITE (20) 1[:]LBS [:] T AVG DAILY AMT(24) <br /> *If EHS, amounts must be in lbs ON-SITE 2 S <br /> LARGEST (21) n � ANNUAL WASTE AMT(25) <br /> CONTAINER L <br /> STORAGE (26) to ABOVE GROUND TANK ❑CAN ❑ BOX [—]TANK WAGON <br /> CONTAINER ❑UNDER GROUND 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 %VvT 30 HAZARDOUS COMPONENT 31 EHS 32 CAS# <br /> s-ev`o gn1t#-/d E I ❑Y N 74 - .54-0 <br /> 7s % P/-GI)r4Iq ❑Y N 1 74 - 96 - 6- <br /> -79o, <br /> — C)6 , 6 <br /> —_.LY I V /�Q L t ❑Y C21 N <br /> 2 -S- lo I I 1311-FqNES j1E1Y2N11 VAR tous <br /> ❑Y ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) <br /> (34)WHAT IS MATERIAL F t?KL ircT e Fi[G�L <br /> USED FOR? /�)0792i <br /> For Official Use Only: ❑ C ❑ R S SIC 12/03 <br />