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FIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION <br /> (mm page per meleid M building or area) <br /> ❑ ADD ❑DELETE ❑ REVISE 209 Page t of I <br /> I.FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> LODI AIRPORT <br /> CHEMICAL LOCATION Y01 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> ❑ YES ❑NO <br /> FACILITY ID# FA0011210 1 MAP#(nptimm0 203 C1FUU (wnecd> 201 <br /> II.CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET ❑ Yes ®No 206 <br /> as If subjact mEPCRA,Wer to mmcct m. <br /> COMMON NAME <br /> 201 EHS" ❑ Yes ® a <br /> No 2 <br /> gas <br /> CAS# 209 <br /> 8006-61-9 "If EHS is"Yes",all amounts below most be in lbs. <br /> FIRE CODE HAZARD CLASSES(Cmnplme irrewimd by COPA) 210 <br /> HAZARDOUS MATERIAL ❑ a PURE ❑ b.MIXTURE ❑ u WASTE 21l RADIOACTIVE [:] Yes ® No 212 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE ❑ a SOLID ® b.LIQUID ❑ c.GAS 211 LARGEST CONTAINER 213 <br /> (Check one item only) 10,000.00 <br /> FED HAZARD CATEGORIES 216 <br /> (Check all that apply) ® a.FIRE ❑ L REACTIVE ❑ c.PRESSURE RELEASE ❑ d.ACUTE HEALTH ❑ e.CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 2"1 I MAXIMUM DAILY AMOUNT 218 1 ANNUAL WASTE AMOUNT 219 STATE W ASTE CODE no <br /> 8,000.00 16 000.00 <br /> UMTS' ® a GALLONS ❑ b.CUBIC FEET ❑ c.POUNDS ❑ d.TONS 221 DAYS ON SITE: 222 <br /> (Check one item only) <br /> •If EHS,amount must be in pounds. 365 <br /> STORAGE ® a ABOVE GROUND TANK ❑ e PLASTIC NONMETALLIC DRUM ❑ i.FfBER DRUM ❑ m.GLASS BOTTLE ❑ q.RAIL CAR <br /> CONTAINER ❑ b.UNDERGROUND TANK ❑ f CAN ❑j.BAG ❑ n.PLASTIC BOTTLE ❑ c OTHER <br /> ❑ c TANK INSIDE BUILDING ❑ g.CARBOY ❑k.BOX ❑0.TOTE BIN <br /> ❑ d.STEEL DRUM ❑ h.SILO ❑I.CYLINDER ❑ p.TANK WAGON 2D <br /> STORAGE PRESSURE ® a AMBIENT ❑ b. ABOVEAMBIENT ❑c. BELOW AMBIENT 221 <br /> STORAGETEMPERATURE ®a AMm= ❑ I. AB(VEAMBIENT ❑ o BELOW AMBIENT ❑ d. CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> 1 226 227 ❑ Yes ❑ No 228 229 <br /> Z no 231 ❑ Yes No 232 233 <br /> 3 231 235 ❑ Yes ❑ No D6 231 <br /> 4 238 239 ❑ Yes ❑ No 210 211 <br /> 5 212 213 Yes 1:1 No 2" 215 <br /> Irmom Lmrdous componeob em preunl vt gmmrthen IM by weight if non<vrcinageni4 or0.1 b by wdght irurunogenic.et1vN etldhianel shots of paper capturing the required informvdon. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION 216 <br /> If EPCRA,Please Sign Here <br /> UPCF(1/99) <br />