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California Hazardous Ms Inventory Form - Chemical Des"n <br /> (1)FEZD ❑DELETE ❑REVISE PAGE(2) = OF(3) <br /> BUSINESS NAME (4) AUTOFIX OF STOCKTON <br /> CHEMICAL LOCATION(S)(5) BACK OF SHOP <br /> MAP#(6)/ GRID#(7) H-3 <br /> CHEMICAL NAME (8) WASTE MOTOR, TRANS HYDRAULIC OILS TRADE SECRET(11) ❑YES ®NO <br /> COMMON NAME (9) <br /> WASTE OIL *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) ❑PURE ®MIXTURE ®WASTE RADIOACTIVE(15) ❑YES ®NO (16) <br /> PHYSICAL STATE(17) ❑SOLID ®LIQUID []GAS CURIES <br /> FED HAZARD ®FIRE [I REACTIVE [I PRESSURE RELEASE El ACUTE HEALTH [j CHRONIC HEALTH <br /> CATEGORIES (l8) <br /> STATE WASTE (19) UNITS*(22) ®GAL ❑LBS MAX DAILY AMT(23 17 0 <br /> CODE 221 ❑CU FT ❑TONS ON SITE <br /> DAYS ON SITE (20)365 *If EHS, amounts must be in lbs AVG DAILY AMT(24) 100 <br /> ON SITE <br /> LARGEST (21 170 ANNUAL WASTE AMT(25) 1200 <br /> CONTAINER <br /> STORAGE (26) ®ABOVE GROUND TANK El CAN [I BOX ❑TAN <br /> CONTAINER []UNDER GROUND TANK []CARBOY ❑CYLINDER ❑RAI <br /> ❑TANK INSIDE BUILDING ❑SILO ❑GLASS BOTTLE ❑Othe <br /> ❑STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BAG [:]TOTE BIN <br /> STORAGE (27) H AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBI <br /> PRESSURE <br /> STORAGE (28) ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT []CRYOGENIC <br /> TEMPERATURE <br /> 29)%WT 30)HAZARDOUS COMPONENT (31)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 <br /> USED FOR? <br /> DATE REC'D: 3/1/01 For Official Use Only: Mc ❑R E1= SIC 12/99 <br />