Laserfiche WebLink
California Hazardous Materials Inventory Form - Chemical Description <br /> (I) ®ADD ❑DELETE =REVISE 2001 PAGE(2) OF(3) <br /> BUSINESS NAME (4) <br /> CHEMICAL LOCATION(S)(5) <br /> <br /> <br /> <br /> TRADE SECRET(11) ❑Y ®N <br /> *EHS (12) ❑Y [AN] <br /> COMMON NAME (9) UX4g2✓I <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) LEAVE BLANK <br /> HAZARD CLASS <br /> TYPE (14) PURE ❑MIXTURE [:]WASTE RADIOACTIVE(15) ❑Y ❑N (16) � <br /> [:)LIQUID <br /> ® CURIES <br /> PHYSICAL STATE(17)I SOLID LIQUID GAS <br /> FED HAZARD ®FIRE REACTIVE PRESSURE RELEASE ❑ ACUTEHEALTH ❑ CHRONIC HEALTH <br /> CATEGORIES (18) <br /> STATE WASTE (19)�� UNITS*(22) ❑GAL, ®CU FT OMAX NSIDE ILY AMT(23) � 0 <br /> CODE ❑LBS []TO <br /> DAYS ON SITE (20) AVG DAILY AMT(24)� <br /> *If EHS, amounts must be in lbs ON-SITE E3� <br /> LARGEST (21� ANNUAL CONTAINERWASTEAMT(25)E= <br /> CONTAER �Z �� <br /> STORAGE (26) ❑ABOVE GROUND TANK ❑ CAN ❑ BOX ❑TANK WAGON <br /> CONTAINER ❑UNDER GROUND TANK ❑CARBOY ® CYLINDER [:]RAIL CAR <br /> ❑TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE ❑-------------------- <br /> ❑STEEL DRUM ❑FIBER DRUM ❑ PLASTIC BOTTLE <br /> ❑PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN <br /> STORAGE (27) El AMBIENT 29 ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC <br /> TEMPERATURE <br /> (29 %WT (30)HAZARDOUS COMPONENT (3� (32 CAS# <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> ❑Y ❑N <br /> F1 F1 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) U n i O'7 a <br /> (34)WHAT IS MATERIAL �` <br /> USED FOR? <br /> For Official Use Only: C ❑ R ❑ S SIC I2/00 <br />