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Ir <br />BUSINESS NAME: <br />CONTACT NAME: <br />SITEADDRESS, <br />Pags 2 of 7 <br />L15T <br />RLL emir -1,11Q <br />Chemical Name: tJtrt <br />AAAt_ICA r <br />Trade Name: 10W - <br />Trade Secret __Yes <br />Waste Classification. <br />p tL. <br />XToxic .ignitable <br />EHS Material —Yes <br />Corrosive _Reactive ®Extremely Hazardous <br />DO T# <br />CAS <br />Number of Days on Site/Year: — <br />Daily Amount Stored: <br />Physical State: <br />--Z49--Max, _ 12Q- - Ave. Units of Measurer®at. Lbs. <br />Physical Hazards: <br />Solid XLiquid ®Gas <br />XFire —Pressure <br />_Cu.Ft, <br />_Mlxture't (must complete components of mixture below) <br />Reactivity <br />Heafth Hazards: <br />Incompatible Materials: <br />`Acute (immeolate) <br />_ <br />® Chronic (delayed) Xlrtftint <br />Storage Type: Aboveground <br />Other: <br />Tank _Underground <br />Tank —Drum _ Cylinder _,_,Secondary Contalnment <br />Storage Pressure: _NItAp4Pta�Rt <br />Storage Location:�ERV1t".E <br />Storage Temperature ( F): <br />i?�tll'�lti)["., <br />ARC1A tfJS1DE <br />Mow i m - -- <br />s aterlalused:_AtTt®Mrr2tvP_ ���wP�,«- -. M <br />1 Mixture: (List the three most hazardous components (by weight): <br />1. - Lt A"t t�G �IL.S OAS # Mt1C'7s)R %wt- q <br />2. CAS# UP�tLG-TA�PNV %wt_5•-10 <br />3. t CAS# PRtC�1AR��°Y®wt_Gs•►S <br />Chemical Name: Trade Secret Yes <br />Trade Name: OW- EHS Material _Yes <br />Waste Classification: 2GToxic X Ign►iable „Corrosive Reactive ®Extremely Hazardous <br />DOT# Q� CAS9 Number of Days on Site/Year: <br />Daily Amount Stored: 24Q Max. 12Q Ave. Unite of Measure: <br />Physical State: Solid X Gal. _Lbs. _Cu.Ft. <br />Physical Hazards: �Lfquid —,Gas _Mixture 61 (must complete components of mixtum wow) <br />Fire _Pressure Reactivity <br />Health Hazards: Acute (immediate) _Chronic (delayed) Xlrrhant <br />incompatible Materials: 6 <br />Storage Type: ,KAbovegmund Tank _Underground Tank <br />Other: <br />Storage Pressure: A m-*' Xl�RIG Storage <br />Storage Location:- <br />How is material used -: AU'10nArriift= r a .,L. Z.. <br />®Drum _Cylinder _Secondary Containment <br />1 Mixture: (List the three mast hazardous components (by weight): <br />1' t CAS#_ ��uwt <br />2. CAS#_PR.o t 2.t��ARY %Wtl <br />3. t <br />CAS# E�_QPSd_�.�BRY %wt_tQ2a <br />FOR OES US3=ONLY; L_ STOTAL#`_ EHg REVIEWED BY INSP"®, <br />9 (b) <br />