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NIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 04/15/2009-02:20:26 PM <br /> Page_ of <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> TOTE-A-SHED INC <br /> <br /> �� <br /> <br /> <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET 01) ❑YES ®NO 206 <br /> ACETYLENE if Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 208 <br /> EHS* ❑YES ®NO <br /> ACETYLENE <br /> CAS# 209 <br /> If EHS is "Yes",all amounts must be in lbs. <br /> ACETYLENE <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HAZARDOUS MATERIAL YES 19 NO 212 CURIES 0 213 <br /> TYPE(Check one item only) ®a.PURE O b.MIXTURE p e.WASTE 211 RADIOACTIVE❑ <br /> 215 <br /> PHYSICAL STATE ❑SOLID ❑LIQUID N GAS 214 LARGEST CONTAINER 200 <br /> (Check one item only) <br /> FED HAZARD CATEGORIES 216 <br /> (Check all that apply) ®O� �REACTIV E ®PRESSURE RELEASE O ACUTE HEALTH ❑CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 400 600 NONE N/A <br /> 221 DAYS ON SITE 222 <br /> UNITS* IJ GAL ®CU FT ❑LBS (J TONS 365 <br /> (Check on item only *If EHS,amount must be in pounds. <br /> STORAGE ❑ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO ❑PLASTIC BOTTLE <br /> p TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM O BAG ❑TANK WAGON <br /> ❑CAN TIC/NONMETALLIC DRUM O CYLINDER ❑OTHER R <br /> 223 <br /> STORAGE PRESSURE ❑AMBIENT ®ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE M AMBIENT E3 ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> WT HAZARDOUS COMPONENT For mizmre or waste onl EHS CAS# <br /> 226 227 ❑YES ❑NO 228 229 <br /> 230 231 [:]YES ❑NO 232 233 <br /> 234 235 ❑YES ❑NO 236 237 <br /> 238 <br /> 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1001 246 <br /> (34)WHAT IS MATERIAL WELDING I <br /> USED FOR? <br /> UPCF(Rev, 12/2007) if EPCRA,Please Sign Here <br /> For Official Use Only. ®C ❑R [IS <br />