Laserfiche WebLink
N%,.tJNIFIED PROGRAM CONSOLIDATED FORsrwof <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY - CHEMICAL DESCRIPTION <br /> 10/14/2009 - 05:11:35 PM) <br /> Page of <br /> 1. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> QUALITY TUNE UP SHOP#11 <br /> CHEMICAL LOCATION 201 HEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> ❑X YES❑NO <br /> FACIIITYID# 1 MAP#GUyS3I ��� 203/204 <br /> 13066 Required by S] '$ <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(1 1) ❑YES ®NO 206 <br /> HIGHLY REFINED MINERAL OIL If Subject to EPCRA.refer to instructions <br /> COMMON NAME 207 EHS* []YES ®NO 208 <br /> MULTI VEHICLE ATF <br /> CAS)Y 209 <br /> MIXTURE "`If EHS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HAZARDOUS MATERIAL a.PURE N b.MIXTURE pc.WASTE 21] RADIOACTIVE YES ®NO 212 CURIES 0 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE 21 i 215 <br /> (Check one item only) <br /> [3 SOLID ®LIQUID []GAS LARGEST CONTAINER 100 <br /> FFD HAZARD CATEGORIES O FIRE ❑REACTIVE [:]PRESS UPE RELEASE O ACUTE HEALTH []CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 50 100 NIA NIA <br /> UNITS* ®GAL ❑CU FT ❑LBS ❑'PONS 221 DAY S ON SITE 222 <br /> (Check on item only *If EHS,amount must be in pounds. 365 <br /> STORAGE ®ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO ❑PLASTIC BOTTLE <br /> ®TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM ❑13AG ❑TANK WAGON <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BOX ❑RAIL CAR <br /> ❑CAN ❑CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TFMPFRATURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste on]) EHS CAS# <br /> 90-100 226 HIGHLY REFINEDMINFRAI-OILS 227 ❑YES ONO 228 N/A 229 <br /> 0-10 230 PROPIETARY 231 [--]YES ONO 232 N/A 233 <br /> NIA 234 NIA 235 ❑YES ®NO 236 NIA 237 <br /> NIA 238 NIA 239 ❑YES ONO 240 NIA 241 <br /> NIA 242 NIA 243 ❑YES ®NO 244 NIA 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) NIA 246 <br /> (34)WHAT IS MATERIAL L <br /> USED FOR? Automotive Service <br /> UPCF(Rev. 1212007) If EPCRA,Please Sign Here <br /> or Official Use Only: ®C ❑R ❑S Last Web Update: 04/16/2009 <br />