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California Hazardou, aterials Inventory Form - Chemicaescription JAN 2 3 2004 PAGE (2) OF (3) BUSINESS NAME (4) �-rIEMICAL LOCATION(S) (5 SIERRA C ME (8) CYANURIC ACID TRADE SECRET (11) ❑ YES ® NO Tra COMMON NAME (9) CONDITIONER *EHS (12) ❑ YES ® NO *IF EHS BOX IS "Y" CAS # (10) N/A ALL AMOUNTS MUST BE IN LBS FIRE CODE (13) HAZARD CATEGORIES LEAVE BLANK TYPE (14) ® PURE [:]MIXTURE ❑WASTE RADIOACTIVE (15) ❑ YES ®NO (16) 0 PHYSICAL STATE (17) IN SOLID [:]LIQUID ❑ GAS CURIES FED HAZARD ❑ FIRE ElREACTIVE ElPRESSURE RELEASE ® ACUTE HEALTH ❑ CHRONIC HEALTH CATEGORIES (18) STATE WASTE (19) UNITS* (22) [:1GAL ® LBS �")DE N/A ❑ CU FT ❑TONS MAX DAILY AMT (23) 900 ON SITE �..YS ON SITE (20) 356 *If EHS, amounts must be in lbs AVG DAILY AMT (24) 650 ON SITE LARGEST (21) 50 ANNUAL WASTE AMT (25) N/A CONTAINER STORAGE (26) CONTAINER STORAGE PRESSURE STORAGE TEMPERATURE ro W 1 ❑ ABOVE GROUND TANK ❑ CAN ❑ BOX ❑ TANb []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 (10) HA7.ARDOI IS COMPONENT (3 1) EHS (32) CAS# )DITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) N/A k-14) WHAT IS MATERIAL FOR SALE USED FOR? DATE REC'D:JAN e� 200 For Official Use Only: ® C [IR [IS SJC 12/99 ❑YES ❑N []YES ❑N ❑YES El DYES ❑N ❑YES El )DITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) N/A k-14) WHAT IS MATERIAL FOR SALE USED FOR? DATE REC'D:JAN e� 200 For Official Use Only: ® C [IR [IS SJC 12/99