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California Hazardous Slerials Inventory Form - Chemical wription <br /> PAGE(2) = OF (3) <br /> BUSINESS NAME (4)TED'S WELDING & REPAIR <br /> CHEMICAL LOCATION(S)(5) <br /> <br /> CHEMICAL NAME (8) CARBON DIOXIDE TRADE SECRET(11) ❑ YES ®NO <br /> COMMON NAME (9) CO2 *EHS(12) ❑YES ®NO <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) 124-38-9 ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) <br /> HAZARD <br /> CATEGORIES <br /> TYPE (14) H PURE ❑MIXTURE ❑WASTE RADIOACTIVE(15) ❑YES ®NO (16) <br /> PHYSICAL STATE(17) ❑SOLID H LIQUID ❑GAS CURIES <br /> FED HAZARD <br /> CATEGORIES (18) ❑FIRE ®REACTIVE ❑PRESSURE RELEASE ❑ACUTE HEALTH ❑CHRONIC HEALTH <br /> STATE WASTE (19) UNITS*(22) ❑GAL H LBS MAX DAILY AMT(23)500 <br /> CODE 1013 ❑CU FT ❑TONS <br /> ONSITE <br /> DAYS ON SITE (20) 365 *If EHS, amounts must be in lbs AVG DAILY AMT(24) 300 <br /> ON SITE <br /> LARGEST (21)275 ANNUAL WASTE AMT(25) <br /> CONTAINER <br /> STORAGE (26)❑ABOVE GROUND TANK ❑CAN ❑BOX ❑TAN <br /> CONTAINER ❑UNDER GROUND TANK ❑CARBOY ®CYLINDER ❑RAIL <br /> ❑TANK INSIDE BUILDING ❑SILO ❑GLASS BOTTLE ❑OTH <br /> ❑STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE ❑Other <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BAG ❑TOTE BIN <br /> STORAGE (27)IN AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT [:]CRYOGENIC <br /> TEMPERATURE <br /> 29 %WT 30 HAZARDOUS COMPONENT (3 1)EHS 32 CAS# <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> OYES ON <br /> ❑YES ❑ N <br /> ❑YES ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1013 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? <br /> DATE REC'D: 9/22/06 For Official Use Only: 0 C 0 R ❑S SJC 12/99 <br />