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AN 14 20T9 <br /> California Hazardous aterials Inventory Form - Chemica' ascription ]AN <br /> (3) <br /> PAGE(2) <br /> BUSINESS NAME (4) TRACY VW <br /> CHEMICAL LOCATION(S)(5) OIL ROOM <br /> MAP#(6)/ GRID#(7) <br /> CHEMICAL NAME (8) USED OIL TRADE SECRET(11) ❑YES ®NO Tra <br /> *EHS(12) ❑YES ®NO <br /> COMMON NAME (9) WASTE OIL <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) N/A 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) <br /> PHYSICAL STATE(17) SOLID H LIQUID []GAS <br /> CURIES <br /> ❑ <br /> FED HAZARD ®FIRE ❑REACTIVE [3 PRESSURE RELEASE ❑ACUTE HEALTH ❑CHRONIC HEALTH <br /> CATEGORIES (18) <br /> STATE WASTE (19) UNITS*(22) ®GAL ❑LBSMAX DAILY AMT(23)500 <br /> CODE 221 ❑CU FT ❑TONS ON SITE <br /> DAYS ON SITE (20) 365 *If EHS, amounts must be in lbs AVG DAILY AMT(24) 200 <br /> ON SITE <br /> LARGEST (21 500 ANNUAL WASTE AMT(25) 1000 <br /> CONTAINER <br /> STORAGE (26)®ABOVE GROUND TANK ❑CAN ❑BOX ❑TAN <br /> CONTAINER ❑UNDER GROUND TANK []CARBOY ❑CYLINDER ❑RAIL <br /> ❑TANK INSIDE BUILDING ❑SILO ❑GLASS BOTTLE ❑OTH <br /> ❑STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE ❑Other <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BAG ❑TOTE BIN <br /> STORAGE (27) ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT <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 /> ❑YES ❑N <br /> ❑YES [:INJI <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) N/A <br /> (34)WHAT IS MATERIAL WASTE OIL <br /> USED FOR? <br /> DATE REC'D: 1/14/05 r1 Official Usc Only: ®C ❑R ❑S SIC 12/99 <br />