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California Hazardous Materials Inventory Form - Chemical Description <br /> (1) ©ADD ❑DELETE ❑REVISE 2001 PAGE(2) 6-9 <br /> BUSINESS NAME (4) u <br /> �L TI <br /> CHEMICAL LOCATION(S)(5) JOAQIJIN COU1Yf4' <br /> <br /> MAP# (6) / GRID#(7) <br /> CHEMICAL NAME (8) TRADE SECRET(11) ❑Y �N <br /> ryt�T CYL �>� <br /> *EHS IFEHS ) ❑Y [3 N] <br /> COMMON NAME (9) G 19'S��; h,� <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) OC)(_, _ l_C ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) LEAVE BLANK <br /> HAZARD CLASS <br /> TYPE (14) ❑PURE ®MIXTURE [—]WASTE RADIOACTIVE(15) ❑Y ®N (16)� <br /> CURIES <br /> PHYSICAL STATE(17)1 [—]SOLID OLIQUID [:]G=AS <br /> FED HAZARD <br /> CATEGORIES (18) FIRE ❑REACTIVE E]PRESSURE RELEASE ❑ ACUTE HEALTH [:] CHRONIC HEALTH <br /> STATE WASTE (19) UNITS* ( )0--22GAL ❑CU FT MAX DAILY AMT(23) <br /> CODE ❑LBS ❑ ON-SITE I J� <br /> TONS <br /> DAILY AMT(24) <br /> DAYS ON SITE (20) � AVG <br /> *If EHS, amounts must be in lbs ON-SITE J----II <br /> LARGEST (21 `1 ANNUAL WASTE AMT(25)� 1 <br /> CONTAINER EO C J <br /> STORAGE (26) 1�ABOVEGROUND TANK ❑ CAN ❑ BOX ❑TANK WAGON <br /> CONTAINER ❑UNDER GROUND TANK ❑CARBOY ❑ CYLINDER [—]RAIL CAR <br /> ❑TANK INSIDE BUILDING ❑ SILO ❑GLASS BOTTLE ❑-------------------- <br /> ❑STEEL DRUM ❑ FIBER DRUM ❑ PLASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN <br /> STORAGE (27) R AMBIENT ❑ABOVE AMBIENT []BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) S AMBIENT ❑ABOVE AMBIENT []BELOW AMBIENT []CR <br /> TEMPERATURE <br /> (29 % T W (30)HAZARDOUS COMPONENT (31)EHS (32 CAS# <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) u n I a0 <br /> 77 <br /> (34)WHAT IS MATERIAL FCR `` <br /> USED FOR? <br /> For Official Use Only: C R [] S SJC 12/00 <br />