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RECEIVED <br /> UNIFIED PROGRAM CONSOLIDATED FORM N�?V - 8 2W7 <br /> HAZARDOUS MATERIALS DAIIJ JUAUUIN UUUN I Y <br /> NCYSERVI ES <br /> HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESC° f <br /> ff one e e material rbuildin creme <br /> ® ADD ❑ DELETE ❑ REVISE 200 Pae 3 of 8 <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3. <br /> N. Clements CA-American Tower Corp., Site#82597 za1. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202. <br /> CHEMICAL LOCATION ❑ YES ® NO <br /> South in compound 204. <br /> I. MAP# 203. GRID# <br /> FACILITY ID# <br /> (Agency use Only) - site drawinq H9 <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205- TRADE SECRET ❑ Yes ® No 206. <br /> Diesel if Subjectw EPCRA Mertoimttucdona <br /> 20]. 208. <br /> COMMON NAME EHS* ❑ Yes ® No <br /> Diesel <br /> 09 <br /> CAS# +If EHS is"Yes,"all amounts below most be in lbs. <br /> Mixture <br /> vo. <br /> FIRE CODE HAZARD CLASSES(Complete ierequired by I«al agency) <br /> 3 213. <br /> HAZARDOUS MATERIAL 0 a.PURE ®b.MIXTURE ❑C.WASTE 211. RADIOACTIVE ❑Yes 0 No 212. C;;;S N/A <br /> TYPE (Check one item only) <br /> 215. <br /> PHYSICAL STATE 214. LARGEST CONTAINER 210 <br /> (Check one item only) ❑a.SOLID 0 b.LIQUID ❑c.GAS <br /> 216. <br /> FED HAZARD CATEGORIES <br /> (Check all that apply) ®a.FIRE ❑b.REACTIVE ❑c.PRESSURE RELEASE ❑d.ACUTE HEALTH 19 e.CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 217. MAXIMUM DAILY AMOUNT 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220. <br /> •57 210 N/A N/A <br /> 221. DAYS ON SITE 222. <br /> '(MTS- ®a.GALLONS ❑b.CUBIC FEET ❑c.POUNDS ❑d.TONS 365 <br /> Check one item only) a HENS amount must be in pounds. <br /> STORAGE <br /> CONTAINER On. ABOVEGROUND TANK ❑e. PLASTIONONMETALLIC DRUM ❑i. FIBER DRUM ❑m. GLASS BOTTLE ❑q. RAILCAR <br /> ❑b. UNDERGROUND TANK ❑f CAN ❑j. BAG ❑n. PLASTIC BOTTLE ❑r. OTHER <br /> ❑c. TANK INSIDE BUILDING ❑g. CARBOY ❑k. BOX ❑o. TOTE BIN <br /> ❑d. STEEL DRUM ❑h. SILO ❑1. CYLINDER ❑p. TANK WAGON 223. <br /> STORAGE PRESSURE ®a. AMBIENT ❑It. ABOVE AMBIENT ❑e. BELOW AMBIENT 224. <br /> STORAGE TEMPERATURE ®a AMBIENT ❑b. ABOVE AMBIENT ❑c. BELOW AMBIENT ❑d. CRYOGENIC 225. <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> I. >99 226 Diesel 227. ❑Yes ® No 228. 68476-34-6 229. <br /> 2. <1 230. Naphthalene 231. ❑Yes ® No 232, 91-20-3 233, <br /> 3. 23d. X15. ❑Yes ❑ No 236. 23]. <br /> 4. 238. 239. ❑Yes ❑ No 240, 241. <br /> 5_ 242. 243. ❑Yes ❑ No 244. 245. <br /> If more hazard...c+mponea are preset at greeter than iR by weight if non-errimogenie,or 0.1%by weight if erainogenic,attach additional sheets of paper capturing the required information. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION 246_ <br /> DOT Hazard Class: N/A <br /> If EPCRA,Please Sign Here. <br /> Note: If this facility is subject to Federal Emergency Planning and Community Right to Know Act(EPCRA)reporting requirements,a signature is required <br /> at the bottom of the form if the page lists any Extremely Hazardous Substance(EHS)handled at or above its Federal Threshold Planning Quantity <br /> (TPQ)or 500 pounds,whichever is less. <br /> UN-020UPCF-7/15 www.unidocs.org Rev.07/24/06 <br />