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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY- CHEMICAL DESCRIPTION <br /> (one PoBe Por mateiel per buildlna or=a) <br /> ❑ ADD ❑ DELETE ❑ REVISE 200 Page 14 of 36 <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> METALSA STRUCTURAL PRODUCTS INC <br /> CHEMICAL LOCATION 20I CHEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> ❑ YES ❑NO <br /> FACILITY ID# FA0007213 I MAP#Ic%,—h 203 GRID#(wfianaB 2I4 <br /> 11.CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET ❑ Yes M No 206 <br /> FIXODINE Z-10 If sabjxl w EPCsA,lert<w im sauw5 <br /> COMMON NAME <br /> FIXODINE Z-10 01 EHS• ❑ Yes ® No 08 <br /> CAS# 209 <br /> IfFHS is"Yes",all amounts below must be in lbs <br /> FIRE CODE HAZARD CLASSES(Canplew d"uimd by CUPA) 210 <br /> HAZARDOUS MATERIAL ❑ a PURE ❑ b.MIXTURE ❑ c.WASTE 211 RADIOACTIVE Yes ® No 313 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE ® a SOLID ❑ b.LIQUID c GAS 214 313 <br /> (Cheek one item only) Q ❑ LARGEST CONTAINER 125.00 <br /> FED HAZARD CATEGORIES 216 <br /> (Check all that apply) ❑ .FIRE ❑ b.REACTIVE ❑ ..PRESSURE RELEASE ❑ d.ACUTE HEALTH ❑ e.CHRONIC HEALTH <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 218 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 375.00 750.00 <br /> UNITS. ❑ a GALLONS ❑ b.CUBIC FEET ® .,POUNDS ❑ d.TONS 221 DAYS ON SITE: 222 <br /> (Chink one item only) <br /> •HEM,amount moat be in pounds. 365 <br /> STORAGE ❑.ABOVE GROUND TANK ❑ e.PLASTIC/NONMETALLIC DRUM ® i.FIBER DRUM ❑ m.GLASS BOTTLE ❑q.RAIL CAR <br /> CONTAINER ❑ b.UNDERGROUND TANK ❑ E CAN [:11 BAG ❑ n.PLASTIC BOTTLE ® r.OTHER <br /> ❑c.TANK INSIDE BUILDING ❑ g.CARBOY ❑ k.BOX ❑ o.TOTE BM <br /> ❑ d.STEEL DRUM ❑ h.SILO ❑ I.CYLINDER ❑ p.TANK WAGON 223 <br /> STORAGE PRESSURE ® . AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ® a AMIBIENT ❑ b. ABOVE AMBIENT ❑ .. BELOW AMBIENT ❑ d. CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> 1 60.00 226 SODIUM PHOSPHATE DIBASIC 221 ❑ Yes ❑ No 328 7558-79-4 229 <br /> 2 30.00 23o TETRASODIUM PYROPHASPHATE 331 YesNo 232 7722_88_5 233 <br /> 3 234 333 ❑ Yes No 236 231 <br /> 4 239 239 Yes No 24o 241 <br /> 5 242 243 ❑ Yes No 244 245 <br /> umore huardous components are pr«nt at greater than 1%by weight anon-carcinogenic,or 0.1.6 by weight if carcinogenic,attach additional sheets of paper capturing the required information. <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION 246 <br /> If EPCRA,Please Sign Here <br /> UPCF(1/99) <br />