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UNIDOCS <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION <br /> (One page per material per building or area) <br /> ❑ ADD ❑ DELETE ❑ REVISE 2ao_ <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as Facility Name or DBA-Doing Business As) 3. <br /> S-Mart#209 <br /> CHEMICAL LOCATION 201. CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> Backroom ❑ YES ® NO ' <br /> FACILITY ID# _ I- MAP#(opnonal) 20q GRID#(Op oral) 204. <br /> (Agency lite Only) <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205. TRADE SECRET 206_ <br /> Sulfuric Acid lfmbjecttoEKRA,mJWtoinmruame ❑Yes ®No <br /> COMMON NAME 207_ EHS* 208. <br /> Lead Acid Battery ❑Yex ®No <br /> CAS# 209. *If EHS is"Yes,"all amounts below must be in lbs. <br /> Various <br /> FIRE CODE HAZARD CLASSES(Complete Ijrequired by COPA) 210. <br /> Corrosive <br /> HAZARDOUS MATERIAL 211.J RADIOACTIVE 212 CURIES 213. <br /> TYPE (Check one item only) ❑a.PURE ®b.MIXTURE [Ie.WASTE ❑Yes ®No N/A <br /> PHYSICAL STATE 214. LARGEST CONTAINER 215. <br /> (Check one item only) ❑a.SOLID ®b.LIQUID ❑c.GAS 29.1 <br /> FED HAZARD CATEGORIES 216. <br /> (Check all that apply) ❑a.FIRE ®It.REACTIVE ❑c.PRESSURE RELEASE ®it.ACUTE HEALTH ®e.CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 217 1 MAXIMUM DAILYAMOUNT 218. ANNUAL WASTE AMOUNT 219. STATE WASTE CODE 220, <br /> 122.55 245.1 N/A N/A <br /> UNITS* M a.GALLONS ❑It.CUBIC FEET ❑C.POUNDS ❑d.TONS 221. DAYS ON SITE 222. <br /> (Check one Nem only) *If EHS,amount must be in pounds. 365 <br /> STORAGE ❑a. ABOVEGROUND TANK Elf CAN Elk. BOX ❑p. TANK WAGON 223. <br /> CONTAINER ❑b. UNDERGROUND TANK ❑g. CARBOY ❑I. CYLINDER ❑q. RAILCAR <br /> ❑c. TANK INSIDE BUILDING ❑h. SILO ❑in. GLASS BOTTLE ®r. OTHER <br /> ❑d. STEEL DRUM ❑i. FIBER DRUM ❑n. PLASTIC BOTTLE <br /> ❑e. PLASTIC/NONMETALLIC DRUM Eli. BAG ❑o. TOTE BIN <br /> STORAGE PRESSURE ®a. AMBIENT ❑b. ABOVE AMBIENT ❑C. BELOW AMBIENT 224, <br /> STORAGE TEMPERATURE 10 a. AMBIENT ❑It. ABOVE AMBIENT ❑c. BELOW AMBIENT ❑d. CRYOGENIC 225. <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> 1. 40 226. Sulfuric Acid 227 ®Yes ❑ No 22829 <br /> 7664-93-9 <br /> 230, 231. 232, 233. <br /> 2. ❑Yes ❑ No <br /> 234, 235. 236, 237. <br /> 3. ❑Yes ❑ No <br /> 238. 239. 240. 241. <br /> 4. 1 ❑Yes ❑ No <br /> 242. 243. 244. 245. <br /> 5. ❑Yes ❑ No <br /> If more hourdoua com,un.0 arc prerent at grater than IR by weight if non-carcinogenic,or 0.1%by weigh)if nr<inogeok,auarh eJJitional rhenr of paper npturing the regnired Information. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION 246 <br /> DOT Hazard Class: <br /> If EPCRA,Please Sign Here. <br /> If this facility is subject to Federal Emergency Planning and Community Right to Know Act(EPCRA)reporting requirements,a signature is required at the <br /> bottom of the form if the page lists an Extremely Hazardous Substance(EHS)handled at or above its Federal Threshold Planning Quantity (TPQ)or 500 <br /> pounds,whichever is less. <br /> S-Mart#209 Page 5 of 20 July 2012 <br />