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California Hazardoup Materials Inventory FoRECENEQscription <br /> (I) ADD DELETE ❑VISE 2005 JUL €13 2Aed PAGE(2) lu OF(3) 12 <br /> BUSINESS NAME (4) pm -rnw-N spcei /W �NCS SE,�iVICES <br /> CHEMICAL LOCATION(S)(5) N' (� <br /> (Within facility,not street <br /> <br /> CHEMICAL NAME (8) �qA/ TRADE SECRET(11) ❑Y ' N <br /> COMMON NAME (9) /)q0T01:p" CIL *EHS(12) ❑Y N <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) 6474-1 „ q _ ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) v <br /> HAZARD CLASS <br /> TYPE (14) [—]PURE MIXTURE ❑WASTE RADIOACTIVE(15) ❑1 N (16) <br /> PHYSICAL STATE(17) ❑SOLID LIQUID ❑GAS CURIES <br /> FED RD <br /> CATEGORIES <br /> FIRE ❑ REACTIVE ❑PRESSURE RELEASE ❑ ACUTEHEALTH ❑ CHROMCHEALTH <br /> CATEGORIES (18) <br /> STATE WASTE (19) UMTS*(22) GAL ❑CU FT MAX DAILY AMT(23) <br /> [:]LBS <br /> CODE NA ON-SITE <br /> LBS ❑TONS <br /> DAYS ON SITE (20) AVG DAII Y AMT(24) 7 C <br /> S *If EHS, amounts must be in lbs ON-BYTE J <br /> LARGEST (21 ANNUAL WASTE AMT(25) N/Q <br /> CONTAINER <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 ❑-------------------- <br /> IL7J1 STEEL DRUM ❑FIBER DRUM ❑ PLASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BAG ❑ TOTE BIN <br /> STORAGE (27)VAMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) EjrAMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGEMC <br /> TEMPERATURE <br /> 29 %WT 30 HAZARDOUS COMPONENT (31) <br /> 31 EHS 32 CAS# <br /> l� 2 % Z/ CompDv r ❑Y N <br /> II <br /> G ' <br /> 72 - 77 c ❑Y N PROPP, C-rR h t <br /> c /7-; ❑Y ❑N <br /> ❑Y ❑N <br /> �� ❑Y ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) i 27O <br /> (34)WHAT IS MATERIAL <br /> USED FOR? <br /> For Official Use Only: 11 C R S SIC 12/03 <br />