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California Hazardous Mate is Inventory Form - Chemical Destiption <br />(1) I ®ADD ❑ DELETE ❑ REVISE <br />BUSINESS NAME (4) RIPON FARM SERVICE <br />CHEMICALLOCATION(S)(5) <br /> <br />CHEMICAL NAME (8) <br />COMMON NAME (9) <br />CAS # (10) <br />FIRE CODE (13) <br />HAZARD <br />CATEGORIES <br />DIURON <br />DIREX 4L <br />330-54-1 <br />VE BLANK <br />PAGE (2) F5 <br />0 OF (3) 116 <br />TRADE SECRET (11) FE -]-)TS ®NO <br />*EHS (12) ❑YES ®NO <br />*IF EHS BOX IS "Y" <br />ALL AMOUNTS MUST BE IN LBS <br />TYPE (14)0PURE ®MIXTURE ❑WASTE RADIOACTIVE (15) ❑yES ®NO(16)N/A <br />PHYSICAL STATE (17) ❑ SOLID ®LIQUID ❑GAS CURIES <br />FED HAZARD <br />CATEGORIES (18)10FIRE ❑ REACTIVE ElPRESSURE RELEASE ® ACUTE HEALTH ®CHRONIC HEALTH <br />STATE WASTE (19) <br />CODE <br />DAYS ON SITE (20) <br />N/A <br />365 <br />LARGEST (21)� <br />❑YES ❑N <br />CONTAINER <br />2.5 GAL <br />UNITS* (22) ® GAL ❑ LBS <br />❑ CU FT ❑ TONS MAX DAII Y AMT (23) 960 <br />ON SITE <br />*If EHS, amounts must be in lbs AVG DAILY AMT (24) 1 S 0 <br />ON SITE <br />ANNUAL WASTE AMT (25) N/A <br />STORAGE (26) [1 ABOVE GROUND TANK <br />CONTAINER []UNDER GROUND TANK <br />❑ TANK INSIDE BUILDING <br />❑ STEEL DRUM <br />❑ CARBOY ❑ CYLINDER ❑ RA <br />❑ SILO ❑ GLASS BOTTLE ❑ Oti <br />❑ FIBER DRUM ® PLASTIC BOTTLE <br />STORAGE (27) ® AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBI <br />PRESSURE <br />STORAGE (28) IN AMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBIENT ❑ CRYOGENIC <br />TEMPERATURE <br />__C29) %WT (30) HAZARDOUS COMPONENT (31) EHS <br />(32) CAS# <br />40.00 DIURON <br />❑YES ON 330.54-1 <br />❑YES ❑N <br />❑YES ❑N <br />❑YES ❑N <br />❑YES 0 <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) N/A <br />(34) WHAT IS MATERIAL RETAIL SALE <br />USED FOR? <br />DATE RECD: 12/14/01 For Official Use Only: 0 C ® R ❑ S SIC 12/99 <br />