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California Hazardous4perials Inventory Form - Chemicaloription <br />PAGE (2) <br />BUSINESS NAME <br />CHEMICAL LOCATION(S) <br />FARM SERVICE <br />(5) <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />CHEMICAL NAME <br />(8) BROMACIL & DIURON <br />TRADE SECRET (11) ❑YES ®NO <br />*EHS (12) ❑YES ®NO <br />COMMON NAME <br />(9) KROVAR <br />❑YES ❑N <br />*IF EHS BOX IS "Y" <br />CAS # <br />(10) 314-40-9, 330-54.1 <br />ALL AMOUNTS MUST BE IN LBS <br />FIRE CODE <br />(13) <br />HAZARD <br />LEAVE BLANK <br />CATEGORIES <br />TYPE <br />(14)❑PURE ®MIXTURE []WASTE RADIOACTIVE(15) ❑yES ®NO(16)� <br />PHYSICAL STATE <br />(17) IN SOLID ❑ LIQUID ❑ GAS <br />CURIES <br />FED HAZARD <br />®FIRE []REACTIVE []PRESSURE RELEASE ®ACUTE HEALTH [I CHRONIC HEALTH <br />CATEGORIES <br />(18) <br />STATE WASTE <br />(19) UNITS* (22) ❑ GAL H LBS MAX DAILY AMT (23)150 <br />NA/ <br />CODE <br />❑ CU <br />FT ❑ TONS ON SITE <br />DAYS ON SITE <br />*If EHS, amounts must be in lbs AVG DAILY AMT (24) 5 0 <br />(20) <br />365 <br />ON SITE <br />LARGEST <br />(21 <br />ANNUAL WASTE AMT (25) NA/ <br />CONTAINER <br />L J <br />STORAGE <br />(26) ❑ ABOVE GROUND TANK <br />[]CAN ❑BOX ❑ TANIS <br />CONTAINER <br />❑ UNDER GROUND TANK <br />[]CARBOY ❑ CYLINDER ❑ RAIL <br />❑ TANK INSIDE BUILDING <br />❑ SILO ❑ GLASS BOTTLE ❑ OTH <br />❑ STEEL DRUM <br />❑ FIBER DRUM ❑ PLASTIC BOTTLE ❑ Other <br />❑ PLASTIC/NONMETALLIC DRUM <br />® BAG ❑ TOTE BIN <br />STORAGE <br />(27) ® AMBIENT —[]ABOVE AMBIENT <br />❑ BELOW AMBIENT <br />PRESSURE <br />STORAGE <br />(28) ® AMBIENT ❑ ABOVE AMBIENT <br />[]BELOW AMBIENT []CRYOGENIC <br />TEMPERATURE <br />(IM rnurr <br />ram uazARnnTra CnMPONF.NT <br />(3 1) EHS (32) CAS# <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) N/A <br />(34) WHAT IS MATERIAL HERBICIDE <br />USED FOR? <br />DATE REC'D: 12/30/04 For Official Use Only: li C ❑ R ❑ S SIC 12/99 <br />Tra <br />®N <br />FY <br />314-40-9 <br />40 DIURON <br />❑YES ®N <br />330-54-1 <br />❑YES ❑N <br />❑YES ❑N <br />❑YES ❑N <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) N/A <br />(34) WHAT IS MATERIAL HERBICIDE <br />USED FOR? <br />DATE REC'D: 12/30/04 For Official Use Only: li C ❑ R ❑ S SIC 12/99 <br />Tra <br />