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IFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRIPTION <br /> (ons pegs po,malsnal psr buildings area) <br /> ❑ ADD ❑ DELETE ❑REVISE 20s Page 4 of <br /> I.FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> GREEN MAN MATERIALS <br /> CHEMICAL LOCATION 301 CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> ❑ YES ❑ NO <br /> FACILITY ID# 1 FA0009034 MAP#(Woonab 203 GRID#(apdm'ab 204 <br /> II.CHEMICAL INFORMATION <br /> CHCMICALNAME 205 TRADESECRET ❑ Yes ®No 204 <br /> OFF ROAD DIESEL If subjw b EPCRA,refer to instructions <br /> COMMON NAME <br /> RED DYE DIESEL 07 HHS- El Yes ® No zoe <br /> CAS# 309 <br /> 64741-44-2 If EHS is"Yes",all amounts below must be in lbs <br /> FIRE CODE HAZARD CLASSES(CmnpkAc tfmquimd by COPA) 210 <br /> HAZARDOUS MATERIAL ❑ a PURE ❑ b.MIXTURE [I c.WASTE 2D RADIOACTIVE C1 Yes ® No 312 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE ❑ e.SOLID M b.LIQUID I] c.GAS 214 LARGEST CONTAINER 215 <br /> (Check one item only) 57.00 <br /> FED HAZARD CATEGORIES 216 <br /> (Check all that apply) ® a.FIRE ❑ b.REACTIVE ❑c.PRESSURE RELEASE ❑ d.ACUTE HEALTH ❑ e.CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 22o <br /> 25.00 57.00 <br /> UNITS- M a.GALLONS ❑b.CUBIC FEET ❑ c.POUNDS ❑ d.TONS 221 DAYS ON SITE: 222 <br /> (Check one item only) 7 <br /> •If EHS,amount must be in pounds. <br /> STORAGE ® a ABOVE GROUND TANK ❑ e.PLASTICNONMETALLIC DRUM ❑ i.FIBER DRUM ❑ ..GLASS BOTTLE ❑ q.RAIL CAR <br /> CONTAINER ❑ b.UNDERGROUND TANK ❑ E CAN ❑i.BAG ❑ n.PLASTIC BOTTLE ❑ r.OTHER <br /> ❑ c.TANK INSIDE BUILDING ❑ g.CARBOY ❑k.BOX ❑ o.TOTE BN <br /> ❑ d.STEEL DRUM ❑ h.SILO ❑ I.CYLINDER ❑ p.TANK WAGON 223 <br /> STORAGE PRESSURE ® e. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT 224 <br /> STORAGETEMPERATURE ® a AMIBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑ d. CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> 1 100.00 236 PETROLEUM DISTILLATE 220 E] Yes E] No 238 64741-22-2 229 <br /> 2 230 231 ❑ Yes No 232 233 <br /> 3 234 233 ❑ Yes No 236 237 <br /> 4 239 - 239 0 Yes 0 No 240 241 <br /> 5 242 243 1:1 Yes El No 244 245 <br /> If more hasardous components am pt msft at gmatsr than I%by weight if non-csrcinogeakq or 0.1%by weight if mrcinogenia attach additional sheets of paper capturing the required information. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION 246 <br /> If EPCRA,Please Sign Here <br /> UPCF(1/99) <br />