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California Hazardous*terials Inventory Form - Chemical 0-cription DEC T <br /> PAGE(2) = OF(3) <br /> BUSINESS NAME (4) JIFFY LUBE #598 <br /> CHEMICAL LOCATION(S)(5) <br /> <br /> CHEMICAL NAME (8) AUTOMATIC TRANSMISSION FLUID TRADE SECRET (11) ❑YES ®NO <br /> COMMON NAME (9) PENNZOIL MULTI-VEHICLE ATF FLUID *EHS(12) ❑YES ®NO <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) MIXTURE ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) <br /> HAZARD LEAVE BLANK <br /> CATEGORIES <br /> TYPE (14)IMPURE ❑MIXTURE ❑WASTE RADIOACTIVE(15) ❑yES ®NO (16)L�J <br /> PHYSICAL STATE(17) ❑SOLID ®LIQUID ❑GAS CURIES <br /> FED HAZARD ®FIRE ❑REACTIVE ❑PRESSURE RELEASE [:]ACUTE HEALTH ❑CHRONIC HEALTH <br /> CATEGORIES (18) <br /> STATE WASTE (19)� UNITS* (22) ®GAL ❑LBSMAX DAILY AMT(23)220 <br /> CODE N/A ❑CU FT ❑TONS ON SITE <br /> DAYS ON SITE (20) 365 *If EHS, amounts must be in Ibs AVG DAILY AMT(24) 110 <br /> ON SITE <br /> LARGEST (21)220 ANNUAL WASTE AMT(25) N/A <br /> CONTAINER <br /> STORAGE (26)®ABOVE GROUND TANK ❑CAN []BOX ❑TAN <br /> CONTAINER []UNDER GROUND TANK []CARBOY ❑CYLINDER ❑RAIL <br /> ®TANK INSIDE BUILDING ❑SILO []GLASS BOTTLE ❑OTH <br /> ❑STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE ❑Other <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BAG []TOT <br /> BIN <br /> STORAGE (27) ®AMBIENT []ABOVE AMBIENT []BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) ®AMBIENT []ABOVE AMBIENT []BELOW AMBIENT []CRYOGENIC <br /> TEMPERATURE <br /> 29 %WT 30 HAZARDOUS COMPONENT (3 1)EHS 32 CAS# <br /> ❑YES ®N <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1270 <br /> (34)WHAT IS MATERIAL TRANSMISSION FLUID SERVICE <br /> USED FOR? <br /> DATE REC'D: 12/19/03 For Official Use Only: ❑C ❑R ❑S SIC 12/99 <br />