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California Hazardous Matrials Inventory Form - Chemical Descrion <br /> (1) ❑ADD ❑DELETE ®REVISE PAGE(2) = OF(3) <br /> USINESS NAME (4)STKN MUD WELLS #22 (ACCT #8487) <br /> CHEMICAL LOCATION(S)(5)6011 TAM O'SHANTER DRIVE (WELL #22): CHLORINE CABINET <br /> MAP#(6)/ GRID#(7) 22/D3 <br /> CHEMICAL NAME (8) CHLORINE TRADE SECRET(11) ❑YES ®NO <br /> COMMON NAME (9) CHLORINE *EHS(12) ®YES ❑NO <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) 7782-50-5 ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) <br /> HAZARD LEAVE BLANK <br /> CATEGORIES <br /> TYPE (14) ®PURE []MIXTURE ❑WASTE RADIOACTIVE(15) ❑yES ®NO (16) N/A <br /> PHYSICAL STATE(17) ❑SOLID []LIQUID H GAS CURIES <br /> FEDD <br /> CATEGORIES (18) ®FIRE ❑REACTIVE ®PRESSURE RELEASE ®ACUTE HEALTH ❑CHRONIC HEALTH <br /> STATE WASTE (19) UNITS*(22) ❑GAL H LBS MAX DAILY AMT(23 150 <br /> CODE 1[ICU FT ❑TONS ON SITE <br /> SAYS ON SITE (20)365 *If EHS, amounts must be in lbs AVG DAILY AMT(24) 150 <br /> ON SITE <br /> ARGEST (21 15 0 ANNUAL-WASTE AMT(25) <br /> CONTAINER <br /> STORAGE (26) ❑ABOVE GROUND TANK []CAN [I BOX [j TAN <br /> CONTAINER []UNDER GROUND TANK []CARBOY ®CYLINDER ❑RAI <br /> ❑TANK INSIDE BUILDING ❑SILO []GLASS BOTTLE ❑Othe <br /> ❑STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM []BAG ❑TOTE BIN <br /> STORAGE (27) ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBI <br /> PRESSURE <br /> STORAGE (28) ®AMBIENT []ABOVE AMBIENT []BELOW AMBIENT ❑CRYOGENIC <br /> TEMPERATURE <br /> 29 %WT 30 HAZARDOUS COMPONENT (3 1)EHS 32 CAS# <br /> ❑YES ❑N <br /> ❑YF,S ❑N <br /> ❑YF.S <br /> —El N( <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1017 <br /> 4)WHAT IS MATERIAL USED FOR? Water treatment <br /> ATE REC'D: For Official Use Only: ❑C ®R ❑S SIC 12/99 <br />