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UNIFIED PROGRAM CONSOLIDATED FORM <br />HAZARDOUS MATERIALS <br />HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRI'�EMEQGINC <br />(04/15/2011- 02:31:35 P <br />Page of <br />I. FACILITY INFORMATION <br />BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) <br />3 <br />AT&T MOBILITY-HWY 4 & S WAVERLY RD <br /> <br /> <br /> <br />©YES❑ NO <br />FACILITY IDN 1 MAPSGRID! <br />13774 Requlrc I by SJC /6—i 4 � /A IA IA 2031204 <br />H. CHEMICAL INFORMATION <br />CHEMICAL NAME 205 TRADE SECRET (11) ❑ YES ® NO 206 <br />HYDROGEN GAS <br />If Subject to EPCRA, refer to instructions <br />COMMON NAME <br />207 <br />HYDROGEN BHS* OYES IWNo 208 <br />CAS O 209 <br />1333-74-0 *II EHS is "Yes", all amounts must be in lbs. <br />FIRE CODE HAZARD CLASSES (Complete if required by CUPA) <br />210 <br />LEAVE BLANK <br />HAZARDOUS MATERIAL <br />TYPE (Check one item only) Ra-PURE O b. MIXTURE L3 c. WASTE 211 <br />RADIOACTIVE O YES N NO 212 <br />CURIES 213 <br />PHYSICAL STATE 214 <br />(Check ono item only) ❑ SOLID ❑ LIQUID O GAS <br />LARGEST CONTAINER 500 2I <br />FED HAZARD CATEGORIES ®FIRE ❑REACTIVE ®P <br />(Check all that apply) RESSURB RELEASE ❑ ACUTE HEALTH ❑ CHRONIC HEALTH 216 <br />AVERAGE DAILY AMOUNT 217 <br />MAXIMUM DAILY AMOUNT 2l8 <br />ANNUAL WASTE AMOUNT 219 <br />STATE WASTE CODE 220 <br />9,566 <br />9,S66 <br />0 <br />N/A <br />UNITS* ❑ GAL ® CU FT ❑ LBS ❑ TONS 221 <br />DAYS ON SITE 2r2 <br />(Check on item only * If EHS, amount must be in pounds. <br />1 365 <br />STORAGE ❑ ABOVE GROUND TANK Q CARBOY O GLASS BOTTLEO Other... <br />CONTAINER O UNDER GROUND TANK ❑ SILO [3PLASTIC BOTTLE <br />O TANK INSIDE BUILDING ❑ FIBER DRUM ❑ TOTE BIN <br />O STEEL DRUM <br />[I BAG ❑ TANK WAGON <br />13C�TIC/NONMETALLIC DRUM C] BOX ❑ RAIL CAR <br />® CYLINDER ❑ OTHER <br />223 <br />STORAGE PRESSURE ❑ AMBIENT N ABOVE AMBIENT ❑ BELOW AMBIENT <br />224 <br />STORAGETEMPURATURE ® AMBIENT ❑ ABOVE AMBIENT p BELOW AMBIENT ❑ CRYOGENIC <br />225 <br />`SWT <br />HAZARDOUS COMPONENT For mixture or waste onl <br />EHS <br />CAS# <br />N/A 226 <br />N/A 227 <br />❑ YES p NO 228 <br />N/A <br />229 <br />N/A 23o <br />NIA 291 <br />❑ YES ❑ NO 232 <br />N/A 233 <br />N/A 2?4 <br />N/A 295 <br />❑ YES ❑ NO 236 <br />N/A 237 <br />N/A 236 <br />NIA 239 <br />O YES p NO 240 <br />N/A <br />241 <br />N/A 242 <br />N/A 243 <br />DYES ❑ NO 244 <br />N/A 245 <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS IDY (DOT) 1049 246 <br />(34) WHAT IS MATERIAL <br />USED FOR? FUEL CELL STAND-BY POWER SUPPLY <br />UPCF (Rev. 12/2007) If EPCRA, Please Sign Here <br />�Nry <br />�RVicF�� <br />