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California Hazardous Materials Inventory Form - Chemical Description <br />(1) 1 ® ADD ❑ DELETE ❑ REVISE <br />BUSINESS NAME <br />CHEMICAL LOCATION(S) <br />MAP # (6) / GRID # (7) <br />FARM SERVICE <br />5) <br /> <br />PAGE (2) = <br />OF (3) F116 <br />CHEMICAL NAME (8) IPRODIONE I TRADE SECRET (11) ❑YES ®NO <br />TYPE <br />(14) ❑PURE ®MIXTURE ❑WASTE <br />RADIOACTIVE (15) ❑yES ®NO (16) N/A <br />PHYSICAL STATE (17) ❑ SOLID ®LIQUID ❑GAS <br />*EHS (12) ❑YES ®NO <br />COMMON NAME <br />(9) <br />ROVRAL 4 <br />(18) <br />STATE WASTE <br />(19) UNITS* (22) ® GAL ❑ LBS <br />CODE <br />N/A ❑ CU <br />*IF EHS BOX IS "Y" <br />CAS # <br />(10) <br />36734-19-7 <br />(20) *If EHS, amounts <br />ALL AMOUNTS MUST BE IN LBS <br />FIRE CODE <br />(13) <br />ON SITE <br />LARGEST <br />(21)� <br />ANNUAL WASTE AMT (25) <br />CONTAINER <br />HAZARD <br />N/A <br />LEAVE BLANK <br />(26) ❑ ABOVE GROUND TANK <br />CATEGORIES <br />CONTAINER <br />❑ UNDER GROUND TANK <br />[]CARBOY ❑ CYLINDER ❑ RAI <br />TYPE <br />(14) ❑PURE ®MIXTURE ❑WASTE <br />RADIOACTIVE (15) ❑yES ®NO (16) N/A <br />PHYSICAL STATE (17) ❑ SOLID ®LIQUID ❑GAS <br />CURIES <br />FED HAZARD <br />❑ FIRE [IREACTIVE ❑ PRESSURE RELEASE ® ACUTE HEALTH El CHRONICHEALTH <br />CATEGORIES <br />(18) <br />STATE WASTE <br />(19) UNITS* (22) ® GAL ❑ LBS <br />CODE <br />N/A ❑ CU <br />FT ❑ TONS MAX DAILY AMT (23) 600 <br />ON SITE <br />DAYS ON SITE <br />(20) *If EHS, amounts <br />must be in lbs AVG DAILY AMT (24) 20 <br />365 <br />ON SITE <br />LARGEST <br />(21)� <br />ANNUAL WASTE AMT (25) <br />CONTAINER <br />2.5 GAL <br />N/A <br />STORAGE <br />(26) ❑ ABOVE GROUND TANK <br />[]CAN ❑BOX ❑ TAN <br />CONTAINER <br />❑ UNDER GROUND TANK <br />[]CARBOY ❑ CYLINDER ❑ RAI <br />❑ TANK INSIDE BUILDING <br />❑ SILO ❑ GLASS BOTTLE ❑ Othe <br />❑ STEEL DRUM <br />❑ FIBER DRUM ® PLASTIC BOTTLE <br />❑ PLASTIC/NONMETALLIC DRUM []BAG ❑ TOTE BIN <br />STORAGE <br />(27) ® AMBIENT []ABOVE AMBIENT <br />❑ BELOW AMBI <br />PRESSURE <br />STORAGE <br />(28) ® AMBIENT ❑ ABOVE AMBIENT <br />[]BELOW AMBIENT []CRYOGENIC <br />TEMPERATURE <br />(29) %WT <br />(30) HAZARDOUS COMPONENT <br />(3 1) EHS (32) CAS# <br />41.6 IPRODIONE <br />❑YES ®N <br />36734-19-7 <br />❑YES ❑N <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 RETAIL SALE <br />USED FOR? <br />DATE RECD: 12/14/01 For Official Use Only: EIC ®R ❑ S SJC 12/99 <br />