Laserfiche WebLink
1 1%co <br /> 1 Jq , �® <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS OgjOESgNdp Z <br /> ' HAZARDOUS MATERIALoS�2INVENTORYO0CHEMICAL DESCRIPTT�IIFM�FNpOU <br /> Page_ of U/ <br /> ' 1. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Dome Business As) 3 <br /> HD SUPPLY DISTRIBUTION SERVICE,LLC(CA094-6502) <br /> 1 CHEMICAL LOCATION 201 HEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> HAZARDOUS WASTE STORAGE AREA DYES❑NO <br /> FACILITY ID# 1 MAP#GRID# 203/204 <br /> 13542 Required by Sj# fC2 A A A A <br /> 1 IL CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) C YES ®NO 206 <br /> NON-RCRA HAZARDOUS WASTE,SOLIDS If Subject to EPCRA,refer to instructions <br /> 1 COMMON NAME 207 208 <br /> NON-RCRA HAZARDOUS WASTE,SOLIDS EHS* D YES ONO <br /> CAS# 209 <br /> 1 NA If EHS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> 1 HAZARDOUS MATERIAL a.PURE ❑b.MIXTURE ®c.WASTE 21 I RADIOACTIVE DYES ONO 212 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE ®SOLID ❑LIQUID ❑GAS 214 LARGEST CONTAINER 215 <br /> (Check one item only) 55 GALLON <br /> 1 FED HAZARD CATEGORIES DFIRE ❑REACTIVE ❑PRESSURE RELEASE OACUTEHFALTH DCHRONICHEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMIIM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 5 15 60 141 <br /> 1 UMTS* D GAL OCU FT O LBS O TONS 221 DAYS ON SITE 222 65 <br /> (Check on item only *If EHS,amount must be in pounds. 3 <br /> STORAGE C ABOVE GROUND TANK D CARBOY D GLASS BOTTLE C Other... <br /> 1 CONTAINER C UNDER GROUND TANK C SILO D PLASTIC BOTTLE <br /> C TANK INSIDE BUILDING D FIBER DRUM D TOTE,BIN <br /> ®STEEL DRUM D BAG C TANK WAGON <br /> ®PLASTIC/NONMETALLIC DRUM C BOX D RAIL CAR <br /> D CAN C CYLINDER D OTHER <br /> 273 <br /> 1 STORAGE PRESSURE ®AMBIENT C ABOVE AMBIENT C BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE O AMBIENT CABOVE AMBIENT C BELOW AMBIENT D CRYOGENIC 225 <br /> 1 %WT HAZARDOUS COMPONENT For mixture or waste onl FHS CAS# <br /> 100 226 NON-RCRA HAZARDOUS WASTE, 227 ❑YES ®NO 228 mixture 229 <br /> sr)l Ing <br /> 230 231 D YES ❑NO 232 )1; <br /> 1 234 235 D YES ONO 236 23- <br /> 238 239 ❑YES ❑NO 240 1_41 <br /> 1 242 243 ❑YES ❑NO 244 '_45 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 2�6 <br /> 1 (34)WHAT IS MATERIAL <br /> USED FOR? WASTE <br /> 1 UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br /> 1 <br />