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California Hazardous Materials Inventory Form - Chemical Deiption <br />(1) ®ADD ❑DELETE ❑REVISE PAGE (2)4 8 OF (3) 116 <br />BUSINESS NAME <br />FARM SERVICE <br />CHEMICALLOCATION(S)(5) <br /> <br />CHEMICAL NAME (8) <br />COMMON NAME (9) <br />CAS # (10) <br />DIURON <br />KARMEX <br />330.54-1 <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) IN SOLID ❑ LIQUID ❑ GAS CURIES <br />FED HAZARD <br />CATEGORIES (18)10FIRE ❑ REACTIVE ❑ PRESSURE RELEASE ® ACUTE HEALTH ❑ CHRONIC HEALTH <br />STATE WASTE (19) UNITS* (22) ❑ GAL ®LBS <br />CODE N/A MAX DAILY AMT (23)1,000 <br />❑ CU FT ❑TONS ON SITE <br />DAYS ON SITE (20) 150 *If EHS, amounts must be in lbs AVG DAILY AMT (24) 100 <br />ON SITE <br />LARGEST (21) 4 Ibs ANNUAL WASTE AMT (25) N/A <br />CONTAINER <br />STORAGE (26)❑ABOVE <br />GROUND TANK <br />El CAN <br />❑BOX <br />❑ <br />CONTAINER <br />❑ UNDER GROUND TANK <br />❑ CARBOY <br />❑ CYLINDER <br />❑ <br />❑ TANK INSIDE BUILDING <br />❑ SILO <br />❑ GLASS BOTTLE <br />❑ <br />❑ STEEL DRUM <br />❑ FIBER DRUM <br />❑ PLASTIC BOTTLE <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 (19.) CAS# <br />SO DIURON ❑YES ®N <br />330-54-1 <br />❑YES ❑N <br />❑YES ❑N <br />❑YES ❑N <br />❑YES 0 N <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) 918 8 <br />(34) WHAT IS MATERIAL AGRICULTURAL HERBICIDE <br />USED FOR? <br />DATE REC'D: 12/14/01 For Official Use Only: HC ❑ R ❑ S SIC 12/99 <br />