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NIFIED PROGRAM CONSOLIDATED FORrI-O' <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION <br /> 05/07/2009- 02:40:15 PM <br /> Page of <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> CRYSTAL VALLEY CELLARS LLC <br /> CHEMICAL LOCATION 201 HEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> QX YES❑NO <br /> FACILITY ID# 1 I MAP#GRID# <br /> ����203/204 <br /> 12301 Required by SJ <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(I1) O YES ®NO 206 <br /> PROPANE If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHS [3 YES ®NO 208 <br /> PROPANE <br /> CAS# 209 <br /> 7498-6 If ENS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HAZARDOUS MATERIAL ®a.PURE ❑b.MIXTURE ❑c.WASTE 211 RADIOACTIVE O YES ®NO 212 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE 214 215 <br /> (Check one item only) O SOLID ❑LIQUID M GAS LARGEST CONTAINER 500 <br /> FED HAZARD CATEGORIES ®FIRE O REACTIVE O PRESSURE RELEASE 0 ACUTE HEALTH ❑CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21S ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 250 500 N/A N/A <br /> UNITS* ®GAL O CU FT O LBS [3 TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only *If EHS,amount must be in pounds. 365 <br /> STORAGE ®ABOVE GROUND TANK O CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER O UNDER GROUND TANK O SILO ❑PLASTIC BOTTLE <br /> ❑TANK INSIDE BUILDING O FIBER DRUM ❑TOTE BIN <br /> O STEEL DRUM O BAG ❑TANK WAGON <br /> ❑PLASTIC/NONMETALLIC DRUM O BOX ❑RAIL CAR <br /> ❑CAN O CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE ®AMBIENT O ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE R AMBIENT O ABOVE AMBIENT ❑BELOW AMBIENT O CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT For mixture or waste on] EHS CAS# <br /> 226 227 ❑YES ❑NO 228 229 <br /> 230 231 ❑YES ❑NO 232 233 <br /> 234 235 ❑YES ❑NO ?36 237 <br /> 238 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1075 246 <br /> (34)WHAT IS MATERIAL [ <br /> USED FOR? FORKLIFT FUEL AND HEATING <br /> UPCF(Rev. 12/2007) If EPCRA,Please Sign Here <br /> or Official Use Only: NC ❑R 0 S Last Web Update: 02/27/2006 <br />