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JAN 2 8 2004 California Hazardou, aterials Inventory Form - Chemic. ascription PAGE (2) = OF (3) BUSINESS NAME (4) ,dEMICAL LOCATION(S) ( CHEMICAL NAME (8) SULFUR DIOXIDE TRADE SECRET (11) 10 YES ®NO COMMON NAME (9) SULFUR DIOXIDE *EHS (12) 10 YES ® NO *IF EHS BOX IS "Y" CAS # (10) 17446-09-5 ALL AMOUNTS MUST BE IN LBS FIRE CODE (13) HAZARD CATEGORIES LEAVE BLANK TYPE (14) ® PURE ❑ MIXTURE ❑ WASTE RADIOACTIVE (15) ❑ YES ®NO (16) 10 PHYSICAL STATE (17) ❑ SOLID ❑ LIQUID H GAS CURIES FED HAZARD ❑ FIRE ® REACTIVE ® PRESSURE RELEASE ® ACUTE HEALTH ❑ CHRONIC HEALTH CATEGORIES (18) STATE WASTE (19) UNITS* (22) ❑ GAL ® LBS CODEN/A ❑ CU FT ❑TONS MAX DAILY AMT (23) 33 650 ON SITE YS ON SITE (20) 365 *If EHS, amounts must be in lbs AVG DAILY AMT (24) 24,913 ON SITE ' LARGEST (21)1 TON CYL ANNUAL WASTE AMT (25) N/A CONTAINER STORAGE (26) CONTAINER STORAGE PRESSURE STORAGE TEMPERATURE ❑ ABOVE GROUND TANK ❑ CAN ❑ BOX ❑ TANK [:]UNDER GROUND TANK ❑ CARBOY ® CYLINDER ❑ RAIL ❑ TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE ❑ OTHI ❑ STEEL DRUM ❑ FIBER DRUM ❑ PLASTIC BOTTLE ❑ Other ❑ PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN (27) ❑ AMBIENT ® ABOVE AMBIENT ❑ BELOW AMBIENT (28) ® AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBIENT ❑ CRYOGENIC (30) HAZARDOUS COMPONENT (3 1) EHS (32) CAS# DITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) 11079 �,4) WHAT IS MATERIAL FOR SALE USED FOR? DATE REC'D: For Official Use Only: 19 C ❑ R 0 S SJC 12/99 Tra ❑ YES ❑ N ❑YES ❑N ❑YES ON ❑YES ON ❑YES ❑ N DITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) 11079 �,4) WHAT IS MATERIAL FOR SALE USED FOR? DATE REC'D: For Official Use Only: 19 C ❑ R 0 S SJC 12/99 Tra