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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS AUG 2 v 2011 <br /> HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRIPTION <br /> (One page per material per building or area) SAN J04OIj <br /> UIN CO <br /> ❑ ADD ❑ DELETE ® REVISE Zea. Page o RVi ES <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as Facility Name or DBA-Doing Business AsJ 3 <br /> CRLLC/76#5447 <br /> CHEMICAL LOCATION 201. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202. <br /> <br /> _ MAP#(Optional) 203. GRID#(Opaonoll) 2aa. <br /> (Agency Use Only) <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205. TRADE SECRET TO- <br /> Petroleum <br /> H drocarbon lrsubjectraEPC",refer 1.fico ,any ❑Yes ®No <br /> COMMON NAME 207. EHS- 209. <br /> Motor Oil Allgrades) ❑Yes ®No <br /> CAS# 209. -If EHS is"Yes,"all amounts below must be in lbs. <br /> 64742-65-0 <br /> FIRE CODE HAZARD CLASSES(Complete ijrequard by CUPA) 210 <br /> I-B Flammable Liquid <br /> HAZARDOUS MATERIAL 211 1 RADIOACTIVE 212 <br /> TYPE (Check PHone item only) [I a. c.WASTE a.PURE ®b.MIXTURE CURIES 213. <br /> r-1 Yes ®No <br /> YSICAL STATE 214. LARGESTCONTAINER 215. <br /> (Check one item only) ❑a.SOLID ®b.LIQUID ❑c.GAS <br /> Quart 0.25gallon) <br /> FED HAZARD CATEGORIES :16 <br /> (Check all mm apply) ❑a.FIRE ❑b.REACTIVE ❑c.PRESSURE RELEASE ❑d.ACUTE HEALTH ❑e.CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 212 MAXIMUM DAILY AMOUNT 219, ANNUAL WASTE AMOUNT 219, STATE WASTE CODE 220 <br /> 35 gallons MAXIMUM <br /> allons <br /> UNITS- ®a.GALLONS ❑b.CUBIC FEET ❑c.POUNDS ❑d.TONS m. DAYS ON SITE 222. <br /> (Check one item only) a If EHS,amount must be in pounds. 365 <br /> STORAGE ❑a. ABOVEGROUND TANK <br /> CONTAINER ❑f CAN [I k. BOX ❑p. TANK WAGON xz3. <br /> ❑b. UNDERGROUND TANK ❑g. CARBOY ❑I. CYLINDER ❑q. RAIL CAR <br /> ❑c. TANK INSIDE BUILDING ❑h. SILO ❑m. GLASS BOTTLE ❑r. OTHER <br /> ❑d. STEEL DRUM ❑i. FIBER DRUM ®n. PLASTIC BOTTLE <br /> ❑e. PLASTIC/NONMETALLIC DRUM ❑I. BAG ❑o. TOTE BIN <br /> STORAGE PRESSURE ®a. AMBIENT ❑b. ABOVE AMBIENT ❑c. BELOW AMBIENT 224. <br /> STORAGE TEMPERATURE ®a AMBIENT <br /> ❑b. ABOVE AMBIENT ❑c. BELOW AMBIENT ❑d. CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> 226. <br /> 1 85% Lubricating Base Oil 22 ❑Yes ® No 228. Various 229. <br /> 230. 231. 232 . <br /> 2. 1% Zinc Compound ❑Yes ® Nn Proprietary 233 <br /> 236. 235. 236. 237 <br /> 3. 15% Additives ❑Yes ONO <br /> Proprietary <br /> 239. 239. 260. <br /> 4• ❑Yes ❑ No z41. <br /> 242. 243, 2aa. 245. <br /> 5• [1 Yes C1 No <br /> umm:hazardous eomponenb are prelim at&reater new 1%by weight if non-earcinoeen{o,oe0.1%br�6,htuc.reinoeenie,amen additional sheets orpaper capturing therequired 9aimdlnrormelion. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION 246, <br /> DOT Hazard Class: Not Hazardous <br /> If EPCRA,Please Sign Here. <br /> UPCFRev. (122007)-6/2 www.unidocs.org <br />