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4b , <br />BUSINESS NAME: <br />CONTACT NAME: <br />SITE ADDRESS: <br />i • L <br />P■::' r 4 : two; <br />•c <br />Page of —7— <br />RLL CH <br />Chemical Name: N4`11i <br />Trade Name: Trade Secret Yes <br />CHS Material Yes <br />Waste Classification: ZToxlc XIgnitable „Corrosive —Reactive _Extremely Hazardous <br />DOT#_12%O CAS# MlX`Ct<BR� Number of Days on She/Year. <br />® c� <br />Daily Amount Stored: 3 Max, t ®� Ave. Units of Measure: Xpal. _Lbs. ®Cu,R, <br />Physical State: Solid }�Liqukf _Gas—Mixture''t (must complete components of mixture below} <br />Physical Hazards: &Fire —Pressure Reactivity <br />Health Hazards: „Acute (immeciate) ® Chronic, (dalayod) Kirritant <br />Incompatible Materials: <br />Storage Type: Aboveground Tank _Underground Tank —Drum —Cylinder <br />Other: .Secondary Containment <br />o <br />Storage Pressure: �`TMOSPt-1 R,tG Stora a Tem eraturo <br />Storage Locatton: - _ P ('F): <br />How is material used: _ <br />s Mixture: (L1dt the three most hazardous components (by weight): <br />1. <br />2. CAS# °1® <br />3. CAS# ,- • <br />GAS# wt <br />% wt <br />Chemical Name: _Nort RPP t�,ta,n.iyt;� <br />Trade Name: _ Trade Secret Yes <br />Waste Classification: 2&Toxk: )!�.ignttable `Corrosive Reactive ®Extremely HazardousEHS nal Yes <br />DOT# iZM CASH M1X`i �R_G� ____ __ Number of Days on Site/Year: <br />Daily Amount Stored: _ 1 rzMax. __ '7• Ave. Unita of Measure: <br />Physical State: _ �Gai. ®tbs.._Cu.Ft. <br />Solid ,Liquid ®Gag _Mixture'i (must complete components of mixture wow) <br />Physical Hazards: ,?SFlre ®,Pressure Reactivity <br />Health Hazards: _,_,Acute (immediate) Chronic (delayed) Xlrrdant <br />Incompatible Materials: No 5E <br />Storage Type: _Aboveground Tank ®Underground Tank Drum <br />Other: ®Cylinder _Secondary Containment <br />Storage Pressure; Storage Storage Location: fl Temperature( F): <br />How is material used: <br />r Mixture: (Ust the three most hazardous components (by weight): <br />1•_ � l.t.�lt2ir�.--r�.�� ,.., • — CAS#_ M�)R..1~ o <br />�• �E`M t E � �v� ®Q®!'1►� CAS# /° wt—agz <br />3.UR PDtw?'1 DE`PR®ca®wTT .�BAPt�tG"tAR�j /,wt <br />�..,._ CAS#wt�e <br />FOR ®ES USE ONLY; L, S1 TOTAL# EHS REVIEWED BY INSP.,,_,_ <br />9 (b) <br />