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California Hazardous Materials Inventory Form - Chemical Dei, iption <br />(1) ® ADD ❑ DELETE ❑ REVISE PAGE (2) ED <br />OF (3) 116 <br />BUSINESS NAME (4)RIPON FARM SERVICE <br />CHEMICAL LOCATION(S) (5) <br /> <br />CHEMICAL NAME (8) <br />COMMON NAME (9) <br />CAS # (10) <br />SETHOXYDIM <br />POAST <br />74051.80-2 <br />FIRE CODE (13) <br />HAZARD LEAVE BLANK <br />CATEGORIES <br />TRADE SECRET (11) ❑YES ®NO <br />*EHS (12) ❑YES ®NO <br />*IF EHS BOX IS "Y" <br />ALL AMOUNTS MUST BE IN LBS <br />TYPE (14) ❑ PURE ® MIXTURE ❑WASTE RADIOACTIVE (15) ❑ yES ®NO (16) N/A <br />PHYSICAL STATE (17) ❑ SOLID H LIQUID ❑ GAS CURIES <br />FED HAZARD <br />CATEGORIES (18) ® FIRE ❑ REACTIVE ❑ PRESSURE RELEASE ® ACUTE HEALTH ® CHRONIC HEALTH <br />STATE WASTE (19) UNITS* (22) ® GAL ❑ LBS <br />CODE N/A ❑ CU FT El TONS MAX Y AMT (23)100 <br />ON SITE <br />DAYS ON SITE (20) 365 *If EHS, amounts must be in lbs AVG DAILY AMT (24) 2 0 <br />ON SITE <br />LARGEST (21) 2 5 GALS ANNUAL WASTE AMT (25) N/A <br />CONTAINER <br />STORAGE <br />(26) <br />❑ ABOVE GROUND TANK <br />❑ CAN <br />❑ BOX <br />❑ TAN <br />CONTAINER <br />❑YES ❑N <br />❑ UNDER GROUND TANK <br />[]CARBOY <br />❑ CYLINDER <br />❑ RAI <br />OYES ON <br />❑ TANK INSIDE BUILDING <br />❑ SILO <br />❑ GLASS BOTTLE <br />❑ Othe <br />❑ STEEL DRUM <br />❑ FIBER DRUM <br />® PLASTIC BOTTLE <br />❑ PLASTIC/NONMETALLIC DRUM <br />❑ BAG <br />❑ TOTE BIN <br />® AMBIENT ❑ ABOVE AMBIENT <br />❑ BELOW AMBI <br />STORAGE (27) <br />PRESSURE <br />STORAGE <br />(28) H AMBIENT ❑ ABOVE AMBIENT <br />❑ BELOW AMBIENT []CRYOGENIC <br />TEMPERATURE <br />iga%MAX" <br />(zm uA7ADnnTTC rnA fPf).TRT.rr <br />(31) EHS <br />(92) rAS# <br />18 SETHOXYDIM <br />❑YES ®N <br />74051-80-2 <br />❑YES ❑N <br />❑YES ❑N <br />❑YES ❑N <br />OYES ON <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) <br />(34) WHAT IS MATERIAL NAIL SALE <br />USED FOR? _- <br />DATE RECD: 12/14/01 For Official Use Only: HC 0 R ❑ S SJC 12/99 <br />