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California Hazardous Serials Inventory Form - Chemical fecription <br />PAGE (2)`OF(3Q� <br />BUSINESS NAME <br />(4) RIPON FARM SERVICE <br />CHEMICAL LOCATION(S) (5) <br /> <br /> <br />CHEMICAL NAME (8) <br />COMMON NAME (9) <br />CAS # (10) <br />FIRE CODE (13) <br />HAZARD <br />CATEGORIES <br />LEAVE BLANK <br />TRADE SECRET (11) ❑ yES ®NO Tra <br />*EHS (12) ❑YES ®NO <br />*IF EHS BOX IS "Y" <br />ALL AMOUNTS MUST BE IN LBS <br />TYPE (14) I29 PURE ❑ MIXTURE ❑ WASTE I RADIOACTIVE (15) 10 YES ®NO (16) <br />PHYSICAL STATE (17) ❑ SOLID H LIQUID ❑ GAS CURIES <br />FED HAZARD <br />CATEGORIES (18)❑ FgRE ®REACTIVE ® PRESSURE RELEASE ® ACUTE HEALTH ❑ CHRONIC HEALTH <br />STATE WASTE (19) UNITS* (22) ® GAL ❑ LBS <br />CODE N/A ❑ CU FT El TON MAX DAILY AMT (23) 5 0 <br />ON SITE <br />DAYS ON SITE (20)*If EHS, amounts must be in lbs AVG DAILY AMT (24) <br />365 <br />ON SITE 20 <br />CONTAINER (21)L� ANNUAL WASTE AMT (25) N/A <br />STORAGE (26) ❑ ABOVE GROUND TANK <br />CONTAINER ❑ UNDER GROUND TANK <br />❑ TANK INSIDE BUILDING <br />❑STEEL DRUM <br />STORAGE (27) <br />PRESSURE <br />STORAGE (28) <br />TEMPERATURE <br />(29) %aWT <br />AMBIENT <br />LJ CAN LJ BOX El <br />® CARBOY ❑ CYLINDER ❑ R <br />❑ SILO ❑ GLASS BOTTLE ❑ 0 <br />❑ FIBER DRUM ❑ PLASTIC BOTTLE ❑ 0 <br />BELOW AMBIENT <br />rim uA7ARnn1rc rnMPnNRUT (11) RT4Q <br />111, 1 A C, <br />12.5 <br />CHLORINE <br />❑YES ®N <br />7782505 <br />❑YES ❑N <br />❑YES ❑N <br />JOY ON11 <br />❑YES N71 <br />I <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) <br />(34) WHAT IS MATERIAL RETAIL SALES <br />USED FOR? <br />DATE REC'T-DEC +)1 2004 For Official Use Only: ❑ C ❑ R R S <br />/A <br />SIC 12/99 <br />