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goo: California Hazardous i._ __.erials Inventory Form -Chemical DL. Iption UAN 14 BUSINESS NAME (4) CHEMICAL LOCATION(S) (5 SIERRA CHEMICAL CO (STKN) CHEMICAL NAME (8) PHOSPHORIC ACID TRADE SECRET (11) 10YES ®NO COMMON NAME (9) N/A *EHS (12) JE1 YES ®NO *IF EHS BOX IS "Y" CAS # (10) 17664-38-2 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) ❑ SOLID ®LIQUID ❑ GAS CURIES FED HAZARD ❑ FIRE ® REACTIVE ❑ PRESSURE RELEASE ® ACUTE HEALTH ❑ CHRONIC HEALTH CATEGORIES (18) STATE WASTE (19) CODE %YS ON SITE (20) LARGEST (21 CONTAINER N/A ❑ BOX 1365 []UNDER GROUND TANK 55 STORAGE (26) CONTAINER UNITS* (22) ® GAL ❑ LBS MAX DAILY AMT (23700 ❑ CU FT ElTONS ON SITE *If EHS, amounts must be in lbs AVG DAILY AMT (24) ON SITE I I 110 ANNUAL WASTE AMT (25) IN/A ❑ ABOVE GROUND TANK ❑ CAN ❑ BOX ❑ TANF []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 STORAGE (27) ®AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBIENT PRESSURE STORAGE (28) ® AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBIENT ❑ CRYOGENIC TEMPERATURE %W I (30) HAZARDOUS COMPONENT (3 1) EHS (32) CAS# ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS fD# (DOT) 11805 (34) WHAT IS MATERIAL IFOR SALE USED FOR? ' ATE REC'D: 1/14/03 For Official Use Only: 9[C ❑ R ❑ S SJC 12/99 ❑YES ❑N P' YES ❑N P' YES ❑N P' YES ❑N IF, YES ❑N ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS fD# (DOT) 11805 (34) WHAT IS MATERIAL IFOR SALE USED FOR? ' ATE REC'D: 1/14/03 For Official Use Only: 9[C ❑ R ❑ S SJC 12/99