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California Hazardous`1%aterials Inventory Form - Chemft Description <br /> ", gADD DELETE REVISE 2002 PAGE(2) I— ti1� <br /> PF 1l )® <br /> BUSINESS NAME (4) �•7 <br /> CAL- o, `' FICEG L <br /> CHEMICAL LOCATION(S)(5) <br /> MAP#(6)/ GRID#(7) <br /> CHEMICAL NAME (8) OQ220.q <br /> TRADE SECRET(11) ❑Y N <br /> COMMON NAME (9) /1 _ *EHS (12) ❑Y ©N <br /> _ �]E'�/'�'anl OX 1d) <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) _C, ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) LEAVE BLANK <br /> HAZARD CLASS <br /> TYPE (14) ©PURE ❑MIXTURE ❑WAS'I'L' RADIOACTIVE(15) �N (16)� <br /> PHYSICAL STATE(17) SOLID DLIQUID ©GAS CURIES <br /> FED HAZARD <br /> CATEGORIES (18) E]FIRE []REACTIVE ❑PRESSURE RELEASE © ACIITEHEALTH ❑ CHRONIC HEALTH <br /> STATE WASTE (19)�� UNITS*(22) ❑GAL ❑CUFT MAX DAILY AMT(23) <br /> CODE ON-SITE <br /> ALBS ❑ TONS <br /> DAYS ON SITE (20) AVG DAILY AMT(24) y <br /> *If EHS, amounts must be in lbs ON-SITE <br /> LARGEST (21) ANNUAL WASTE AMT(25) <br /> CONTAINER <br /> STORAGE (26) ❑ABOVE GROUND TANK ❑ CAN ❑ BOX ❑TANK WAGON <br /> CONTAINER ❑UNDER GROUND TANK ❑CARBOY © CYLINDER ❑RAIL CAR <br /> ❑TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE El-------------------- <br /> El STEEL DRUM F�FIBER DRUM PLASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM Q BAG ❑ TOTE BIN <br /> STORAGE (27) ❑ AMBIENT 0 ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) AMBIENT ❑ABOVEAMBIENT ❑BELOWAMBIENT ❑CRYOGENIC <br /> TEMPERATURE <br /> 29 %WT 30 HAZARDOUS <br /> SCCOMPONENT31 EIH�S r 32 CAS# <br /> A�1j c r ❑Y [gN L i5q734— <br /> [:]Y [–]N <br /> .34—[:]Y [–]N <br /> ElY 1:1N <br /> ❑Y ❑N l <br /> �Y QN <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) <br /> (34)WHAT IS MATERIAL _ <br /> USED FOR? e(�i <br /> For Official Use Only: [] C R S SIC 12/01 <br />