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California Hazardous M�Wrials Inventory Form - Chemical De3§iption <br /> (1) ®ADD ❑DELETE ❑REVISE PAGE(2) El OF(3) <br /> BUSINESS NAME (4)APPLEBEE'S NEIGHBORHOOD GRILL/BAR <br /> CHEMICAL LOCATION(S)( <br /> <br /> CHEMICAL NAME (8) CARBON DIOXIDE TRADE SECRET(11) ❑YES ®NO <br /> COMMON NAME (9) CO2 *EHS(12) YES ®NO <br /> *IF EHS BOX IS "Y" <br /> CAS # (10) 124-38-9 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 ❑LIQUID ®GAS CURIES <br /> FED HAZARD CATEGORIES (18)10FIRE ❑REACTIVE IN PRESSURE RELEASE ❑ACUTE HEALTH ❑CHRONIC HEALTH <br /> STATE WASTE (19) UNITS* (22) ❑GAL ®LBS <br /> CODE ❑CU FT ❑TONS MAX DAILY AMT(23)400 <br /> ON SITE <br /> DAYS ON SITE (20)365 *If EHS, amounts must be in lbs AVG DAILY AMT(24) 240 <br /> ON SITE <br /> LARGEST (21 400 ANNUAL WASTE AMT(25)� <br /> CONTAINER <br /> STORAGE (26) ®ABOVE GROUND TANK ❑CAN ❑BOX ❑TAN <br /> CONTAINER ❑UNDER GROUND TANK ❑CARBOY N 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 /> ❑YES ❑N <br /> ❑YES ❑ N <br /> ❑YES ❑N <br /> ❑YES ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1013 <br /> (34)WHAT IS MATERIAL Dispensing soft drinks <br /> USED FOR? <br /> SIC 12/99 <br /> DATE REC'D: 4/12/02 r Official Use Only: ®C El ❑S <br /> Fr <br />