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California Hazardous Matials Inventory Form - Chemical Deefription ® ABOVE GROUND TANK ❑ CAN (1) ® ADD ❑ DELETE ❑ REVISE CONTAINER PAGE (2) = OF (3) 116 BUSINESS NAME (4)IRIPON FARM SERVICE CHEMICAL LOCATION(S) (5) CHEMICAL NAME (8) AMMONIUM THIOSULFATE TRADE SECRET (11) ❑YES ®NO COMMON NAME (9) THIO-SUL *EHS (12) ❑YES ®NO *IF EHS BOX IS "Y" CAS # (10) 7783-18-89 ALL AMOUNTS MUST BE IN LBS FIRE CODE (13) HAZARD LEAVE BLANK CATEGORIES TYPE (14) ❑ PURE ® MIXTURE ❑WASTE RADIOACTIVE (15) ❑ YES ®NO (16) N/A PHYSICAL STATE (17) ❑ SOLID ®LIQUID ❑ GAS CURIES FED HAZARD CATEGORIES (18)I❑ FIRE []REACTIVE ❑PRESSURE RELEASE ® ACUTE HEALTH ❑ CHRONIC HEALTH STATE WASTE (19) UNITS* (22) ® GAL ❑ LBS CODE N/A ❑ CU FT ❑ TONS MAX DAILY AMT (23 5,000 ON SITE DAYS ON SITE (20) 36 5 *If EHS, amounts must be in lbs AVG DAILY AMT (24) 2,500 ON SITE LARGEST (21)6500 ANNUAL WASTE AMT (25)N/A CONTAINER STORAGE (26) ® ABOVE GROUND TANK ❑ CAN ❑ BOX ❑ TAN CONTAINER ❑ UNDER GROUND TANK [:]CARBOY ❑ CYLINDER ❑ RAI ❑ TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE ❑ Othe ❑ STEEL DRUM ❑ FIBER DRUM ❑ PLASTIC BOTTLE ❑ PLASTIC/NONMETALLIC DRUM ❑ BAG ❑ TOTE BIN STORAGE (27) ® AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBI PRESSURE STORAGE (28) IN AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBIENT ❑ CRYOGENIC TEMPERATURE (291 %aVT (10) HA7ARDOTTS COMPO NF.NT (31) EHS (32) CAS# 55.00 AMMONIUM THIOSULFATE ❑YES NNO 7783-18-89 ❑YES ❑N ❑YES ❑N ❑YES ❑N ❑YES ❑N ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) N/A (34) WHAT IS MATERIAL RETAD, SALE USED FOR? DATE REC'D: 12/14/01 For Official Use Only: 0 C 0 R ❑ S SJC 12/99