COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

California Hazardous terials Inventory Form - Chemical' cription 'i 1 BUSINESS NAME N.HEMICAL LOCATION(S) MAP # (6) / GRID # (7) PAGE (2) OF (3) (4) SIERRA CHEMICAL CO (STKN) 5) CHEMICAL NAME (8) INHIBITOR CROWN L60B COMMON NAME (9) ACID INHIBITOR CAS # (10) SEE HAZARDOUS COMPONENTS FIRE CODE (13) HAZARD CATEGORIES LEAVE BLANK TRADE SECRET (11) ❑ YES ® NO *EHS (12) ❑ YES ® NO *IF EHS BOX IS "Y" ALL AMOUNTS MUST BE IN LBS TYPE (14) ❑ PURE ® MIXTURE =ASTE RADIOACTIVE (15) ❑ YES ®NO (16) PHYSICAL STATE (17) ❑ SOLID ®LIQUID ❑ GAS CURIES FED HAZARD ❑ FIRE ❑ REACTIVE ❑ PRESSURE RELEASE ❑ ACUTE HEALTH ❑ CHRONIC HEALTH CATEGORIES (18) STATE WASTE (19) "ODE N A _ iYS ON SITE (20) 1365 LARGEST (21) CONTAINER 55 STORAGE (26) CONTAINER UNITS* (22) ® GAL El LBS MAX DAILY AMT (23) 55 ❑ CU FT ❑ TONS ON SITE *If EHS, amounts must be in lbs AVG DAILY AMT (24) 25 ON SITE ANNUAL WASTE AMT (25) INA :1 ❑ ABOVE GROUND TANK ❑ CAN ❑ BOX ❑ TANK [:]UNDER GROUND TANK ❑ CARBOY ❑ CYLINDER ❑ RAIL ❑ TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE ❑ OTHE ❑ STEEL DRUM ❑ FIBER DRUM ❑ PLASTIC BOTTLE ❑ Other ® PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN STORAGE (27) ® AMBIENT ❑ ABOVE AMBIENT [--]BELOW AMBIENT PRESSURE STORAGE TEMPERATURE (28) ® AMBIENT [:]ABOVE AMBIENT ❑ BELOW AMBIENT [:]CRYOGENIC (30) HAZARDOUS COMPONENT (3 1) EHS (32) CAS# POLYETHYLENEPOLYAMINE ❑ YES ®N 68603-67-8 COCO AMINE 11 ❑ YES ON 61791-14-8 METHENAMINE ❑ YES ®N 100-97-0 HYDROGEN CHLORIDE ❑ YES ON 7647-01-0 ❑YES ❑N 1DITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) INA ) WHAT IS MATERIAL IFOR SALE USED FOR? DATE REC'D: 8/3/05 For Official Use Only: 0 C ❑ R ❑ S SJC 12/99 Tra