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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/21/2010-01:26:31 P <br /> Page of <br /> I. FACILITY INFORMATION <br /> BUSINESS NAM <br /> <br /> AL LOCATION 201 7CAL LOCATION <br /> 2 ABOVE GROUND FUEL TANKS AT FUEL ISLAND OX YES❑NO <br /> FACILITY ID# 1 I MA # <br /> Required by SJ &3HE====203/204 <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) ❑YES ®NO 206 <br /> DIESEL FUEL#2 If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHS ❑YES N NO 208 <br /> DIESEL <br /> CASN 209 <br /> CAS# 346 *If EHS is "Yes",all amounts mast be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if requited by CUPA) 210 <br /> LEAVE BLANK <br /> HAZARDOUS MATERIAL 3 a.PURE E b.MIXTURE p c.WASTE 211 RADIOACTIVE❑YES H NO 212 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE215 <br /> (Check one item only) ❑SOLID ®LIQUID ❑GAS 214 LARGEST CONTAINER 25,000 <br /> FED HAZARD CATEGORIES Ig FIRE M RF-AL-rIVE ®PRESSURE RELEASE ®ACUTE HEALTH ®CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 JANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 25,080 45,000 <br /> UNITS' O GAL ❑CU FT ❑LBS ❑TONS 221 DAYS ON SITE 222 <br /> (Check on item only s If EHS,amount must be in pounds. 365 <br /> STORAGE ®ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO ❑PLASTIC BOTTLE <br /> ❑TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM ❑BAG ❑TANK WAGON <br /> ❑PLASTICINONMETAIMIC DRUM ❑BOX ❑RAIL CAR <br /> ❑CAN ❑CYLINDER ❑OTHER 223 <br /> STORAGE PRESSURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture 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 /> 238 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1993 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? FUEL FOR TRUCKING FLEET <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />