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Non-Waste Hazardous Materials Inventory Statement Date: 07/01/2018 For use by Unidocs Member Agencies or where approved by your Local Jurisdiction Business Name: Quality Express Lube and Smog Type of Report on This Page: Page of (Same as Facility Name) ❑Add; ❑Delete; ❑Revise (One page per building or area) Chemical Location: EPCRA Confidential Location? ❑Yes; ®No I Facility ID# _ _ (Building/Storage Area) Trade Secret Information? ElYes; ®No I (Agency u-Only) 1. 2. 3. 4. 5. 6. 7. 8. 9. Map and Hazardous Components Type Quantities Storage Codes Grid or_ (For mixtures only) and Haz. Location Chemical o Physical —Max—.--Average Largest Storage storageHa^��"' Class Code Common Name Name Wt. EHS CAS No. State Daily Daily Cont. Units Pressure Temp. Categories Base Lubricating Oils 75 DI Mixture ❑pug 280 140 150 ®dons ®ambient ®amhiem ®fire Motor Oil Detergentllnhibitor System 10 ❑ Mixture ®mixture ❑ponds ❑>amb. ❑>amb. ❑reactive Vixcosity Index Improver 15 El Mixture ❑solid Curies: Days On Starege [:]cu.fed ❑<amb. El<amb. El pressure release ❑ ❑ ®liquid (if Aoa thv) Site: Container:" Eltons ❑cryogenic E]aartehealth CAS No.: FAC 365 A ❑chronic health ❑ ❑gas ❑radioactive Base Lubricating Oils 75 ❑ Mixture ❑pure ®gallons ®ambient ®ambient ®fire Transmission Fluid Detergent/Inhibitor System 10 ❑ Mixture ®mixture 85 45 85 ❑Pis ❑>amb. ❑>arab. ❑reactive Vixcosity Index Improver 15 ❑ Mixture ❑solid Curies: Days On Storage ❑cu.f®<amb. ❑<amb. ❑pressurerelesse ®liquid flrradioacusc) Site: Container.' ❑tons ❑cryogenic ❑chroniacute health CAS No.: ❑EHS ❑ ❑ 365 A ❑chronic health ❑ gas ❑radioactive Ethylene Glyocol Solution 50 ❑ 107-21-1 ❑pure110 50 110 ®gallons ®ambient ®ambient ®fire Coolant Water 50 ❑ ®mixture ❑Pounds ❑>amb. ❑>amb. ❑reactive ❑ [I solid Curies: Days On Storage ❑cu.feet ❑<antb. ❑<amb. ❑Pressurerelease (lfradfoxtht) Site: Container.' ❑tons ❑cryogenic ❑chroniacute c tea CAS No.: ❑EHS ❑ alth ❑galiqs 365 A ❑chronic health ❑ ❑g� ❑radioactive 1,1,1,2-Tetraflouroethane 100 E] 811-97-2 ®pure LJ gallons ®ambient ®ambient ®fire ❑ El mature 30 15 30 ®pounds E]>arab. E]>arab. ❑reactive R-1 34A(refrigerant) ❑ [I solid Curia: Days On Storage ❑aL feet ❑<amb. ❑<amb. ®pressure release ❑liquid tB�10a�x) Site: Container.• El tons El cryogenic [Iaaneheahh CAS No. ❑EHS El ❑ El chronic health ❑ PS ❑radioactive ❑ ❑pure ❑gallons ❑ambient ❑ambient ❑fire ❑ ❑mixture ❑Pounds ❑>arab. ❑>arab. ❑reactive Curies: Days On Storaee ❑c.fed <avtb. ❑<amb. ❑pyre release El El solid ❑ ❑cryogenic El acute health El liquid (Ifradioacme) Lite. Container.' tons No.: ❑ EHS El ❑chronic health ❑ ❑gas ❑radioactive ❑ ❑pure ❑gallons ❑ambient ❑aznbient ❑fire ❑ ❑mixture ❑Pounds ❑>amb. ❑>arab. ❑reactive Curies HsOStoraee ❑cu.feet <amb. ❑<amb. ❑Pressure release ❑ ❑solid ❑ ❑cryogenic ❑acute health figtuid (Irradrttne) Container.' tons CAS No. ❑EHS ❑ ❑chronic health ❑ I ❑gas ❑rndioactive Code Storage Tvoe Code Storage Tvne Code Storage Tvne Code Storage Tvoe Code Storage Tvoe Code Storage Type If EPCRA,sign below: A Aboveground Tank D Steel Drum G Carboy J Bag DS Glass Bottle or Jug P Tank Wagon B Belowground Tank E Plastic/Non-metallic Drum H Silo K Boa N Plastic Bottle or Jug Q Rail Car C Tank Inside Building F Can I Fiber Drum L Cylinder O Tote Bin R Other UN-020 www.unidocs.org 7/17-Rev.12/14/10