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BUSINESS NAME: <br />CONTACT NAME: <br />SITEADDAESS: <br />IST <br />Page -7— of -2-- <br />Chemical Name: t) I APP . I raa,t <br />Trade Name: t_ Trade Secret yGs <br />Waste Classification;ENS Material Yes <br />?STox{c Z41gnitable Corrosive _,Reactive ®Extremely Hazardous <br />DOT#_2LLn CAS # Mtx•-t'tti2 Number of Days on She/Year. <br />Daily Amount Stored: May, -15.0 -_Ave. Units of Measure: <br />Physical State: SolidXGal..._Lbs• _Cu.F1. <br />�,Liquld ._._Gas ,_Mixture i (must complete components of mixture bolow) <br />Physical Hazards: XFire _Pressure — Reactivity <br />Health Hazards: X -Acute (immediate) X Chronic (delay®d)Irrttant <br />Incompatible Materials: Aoti1C_ <br />Storage Type: ,Aboveground Tank Underground Tank ®Drum — Cylinder <br />Other: �C,Secondary Contalnment <br />Storage Pressure:n�',p�ttz <br />Storage Location: Storage Temperature (F)RObP/t <br />C)tl't S tp��� _ <br />How is material used: Amr->mrrin Ir- a ..n-. _ <br />i Mixture: (List the three most hazardous components (by weight): <br />2. S 1. CAS#_ nn01c• v� %wt_ DO <br />3. CAS# %wt! <br />CAS# % wt _ <br />Chemical Name: <br />Trade Name: Trade Secret Yes <br />Waste Classification: _Z _ EHS Material Yes <br />,Toxic �lgntiable ,,,_Corrosive _„Reactive ®Extremely Hazardous <br />DOT#CAS Number of Days on Site/Year: -r�2 <br />Daily Amount Stored: ____Max, _ 3 -3 Ave. Units of Measure: yGal. • Lbs. �Cu.Ft. <br />Physical State: Solid XLiquid _,Gas Mixture ®f (must complete components of mixture wow) <br />Physical Hazards: '&Flre _Pressure e Reactivity <br />Health Hazards: XACcrte (immediate) X Chronic (delayed) YJrrhant <br />Incompatible Materials: <br />Storage Type:,Aboveground Tank ®Underground Tank <br />Other: DrtJm ®Cylindor _Secondary Containment <br />Storage Pressure: gfNt t?SP�}•� <br />Storage Location: - <br />-----Storage Temperature ( F): OM <br />How is material used:_AITIotuwert t%, r- r n,., ...... .,.. _ ,. _ _ `1 CIA <br />I Mixture: (List the three mast hazardous components (by weight): ~ <br />1.---�-'E �r�bMn'ttye rrQiA •r -r CAS# wt <br />3. CAS# % wt —A� <br />CAS# % W1FOR OES USE ONLY: t._ S® T(7TAL#� �T <br />EHS REVIEWED BYINSP„� <br />9 (b) <br />KA10-S) <br />