Laserfiche WebLink
0 s <br />California Hazardous Materials Inventory Form - Chemical Description <br />FiADD DELETE REVISE 2001 PAGE (2) =OF(3)� <br />BUSINESS NAME (4) <br />at N STI I,(e '-70J p j e. <br />CHEMICAL LOCATION(S) (5) <br /> <br /> <br /> t31�iGE 6ENG`ISERNC <br />CHEMICAL NAME (8) �fOp,Dr�C, - PhuS�p,aR,( f��d TRADESECRET(II) ❑Y N <br />*EHS (12) ❑Y <br />COMMON NAME (9) �� /�" - � v�'e K IO O0 <br />*IF EHS BOX IS "Y" <br />CAS # (10) 1 ry_:i K+N i- ALL AMOUNTS MUST BE IN LBS <br />FIRE CODE (13) <br />HAZARD CLASS <br />TYPE (14) <br />PHYSICAL STATE (17) <br />FED HAZARD <br />CATEGORIES (I8; <br />STATE WASTE (19. <br />CODE <br />DAYS ON SITE (20 <br />LARGEST (21 <br />CONTAINER <br />STORAGE (26 <br />CONTAINER <br />STORAGE (27 <br />PRESSURE <br />STORAGE (2E <br />TEMPERATURE <br />❑SOLID ❑LIQUID ❑GAS <br />\1.1..,..., <br />El <br />❑Y N <br />i2dC <br />3 a <br />❑ FIRE ❑ REACTIVE ❑ PRESSURE RELEASE <br />ACUTE HEALTH ❑ CHRONIC HEALTH <br />UNITS* (22) AL ❑ CU FT <br />MAX DAILY AMT (23) 33 (7 <br />ON-SITE <br />❑ LBS E] TONS <br />3 % S *If EHS, amounts must be in lbs <br />AVG DAILY AMT (24)� <br />ON-SITE <br />s� ANNUAL <br />WASTE AMT (25)� I <br />❑ ABOVE GROUND TANK ❑ CAN <br />❑ BOX ❑TANK WAGON <br />❑ UNDER GROUND TANK ❑ CARBOY <br />❑ CYLINDER ❑ RAIL CAR <br />❑ TANK INSIDE BUILDING ❑ SILO <br />❑ GLASS BOTTLE ❑-------------------- <br />❑ STEEL DRUM ❑ FIBER DRUM <br />❑ PLASTIC BOTTLE <br />�LASTIC/NONMETALLIC DRUM ❑ BAG <br />❑ TOTE BIN <br />AMBIENT ❑ ABOVE AMBIENT ❑BELOW AMBIENT <br />AMBIENT ❑ ABOVE AMBIENT ❑BELOW AMBIENT ❑ CRYOGENIC <br />- rv� <br />rrii i A.Ns <br />nvrrvivc� <br />\1.1..,..., <br />El <br />❑Y N <br />i2dC <br />3 a <br />❑Y❑N <br />❑Y❑N <br />❑Y ❑N <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: <br />(33) UNITED NATIONS ID # (DOT) I I _f/PU I <br />(34) WHAT IS MATERIAL uyN AiyiY)1a ifesey Aye <br />USED FOR? <br />For Official Use Only: W C ❑ R [] S <br />SJC 12/(10 <br />