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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIINVENTORY <br /> PM CHEMICAL DESCRIPTION <br /> (04/15/2,009 <br /> Page_ of <br /> I. FACILITY INFORMATION <br /> 3 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) <br /> TOTE-A-SHED INC <br /> <br /> ��—.�---���— off YESQNOO <br /> <br /> <br /> <br /> <br /> H. CHEMICAL INFORMATION <br /> 205 TRADE SECRET(11) ❑YES ®NO 206 <br /> CHEMICAL NAME <br /> OXYGEN If Subject to FPCRA,refer to instructions <br /> 207208 <br /> COMMON NAME EHS- <br /> OXYGEN <br /> ®NO <br /> OXYGEN <br /> CAS# 209 *If EHS is "Yes",all amounts must be in lbs. <br /> N/A 2l0 <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) <br /> LEAVE BLANK 213 <br /> HAZARDOUS MATERIAL ®a.PURE O b.MIXTURE O c.WASTE 211 RADIOACTIVE❑YES ®NO 212 CURIES <br /> TYPE(Check one item only) 215 <br /> PHYSICAL STATE ❑SOLID ❑LIQUID ®GAS 214 LARGEST CONTAINER 200 <br /> (Check one item only) 216 <br /> FED HAZARD CATEGORIES ❑ORE ®REACTIVE ®PRESSURE RELEASE ❑ACUTE HEALTH ❑CHRONIC HEALTH <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 N/A <br /> ATE WASTE CODE 220 <br /> 500 500 0 <br /> 221 DAYS ON SITE 222 <br /> UNITS* ❑GAL ®CU IT ❑LBS ❑TONS 365 <br /> (Check on item only *It ENS,amount must be in pounds. <br /> STORAGE ❑ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO [3PLASTIC BOTTLE <br /> TOTE BIN TANK INSIDE BUILDING ❑AR DRUMWAGONp PTEEL DRUM LASIC/NONMETALLIC <br /> DRUM ❑BOX ❑RAIL CAR <br /> ❑CAN ®CYLINDER El OTHER 223 <br /> STORAGE PRESSURE ❑AMBIENT JNg ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ®AMBIENT [3 ABOVE AMBIENT [3 BELOW AMBIENT [3 CRYOGENIC <br /> 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste out EHS CAS# <br /> 226 227 ❑YES ❑NO 228 229 <br /> 230 <br /> 231 ❑YES ❑NO 232 233 <br /> 235 ❑YES ❑NO 236 237 <br /> 234 <br /> 239 ❑YES ❑NO 240 241 <br /> 238 <br /> 243 ❑YES ❑NO 244 245 <br /> 242 <br /> 246 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1072 <br /> L <br /> (34)USED <br /> ES DFOR�TERIAL WELDING <br /> B EPCRA,Please Sign Here <br /> UPCF(Rev. 12/2007) <br /> or Official Use Only: ®C ❑R [IS <br />