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California Hazardous Mat• is Inventory Form - Chemical Description <br />® ADD ❑ DELETE ❑ REVISE PAGE (2)1 OF 3 OF (3) 116 <br />BUSINESS NAME <br />FARM SERVICE <br />CHEMICAL LOCATION(S) (5) <br /> <br /> <br /> <br /> <br />❑YES ❑N <br />❑YES ❑N <br />CHEMICAL NAME <br />(8) <br />METHYL PARATHION <br />TRADE SECRET (11) ❑YES ®NO <br />COMMON NAME <br />(9) <br />PENNCAP M <br />*EHS (12) ®YES ❑ NO <br />*IF EHS BOX IS "Y" <br />CAS# <br />(10) <br />298-00-0 <br />ALL AMOUNTS MUST BE IN LBS <br />FIRE CODE <br />(13) <br />HAZARD <br />CATEGORIES <br />LEAVE BLANK <br />TYPE <br />(14) <br />❑ PURE ®MIXTURE ❑ WASTE <br />RADIOACTIVE (15) ❑ yE S ®NO (16) N/A <br />PHYSICAL STATE <br />(17) <br />❑ SOLID ®LIQUID ❑ GAS <br />CURIES <br />FED HAZARD <br />CATEGORIES <br />(18)® <br />FIRE ❑ REACTIVE ❑ PRESSURE RELEASE H ACUTE HEALTH [:]CHRONIC HEALTH <br />N/A <br />UNITS* (22) ® GAL ❑ LBS MAX DAILY AMT (23)1,000 <br />[ICU FT ❑ TONS ON SITE <br />STATE WASTE (19) <br />CODE <br />DAYS ON SITE <br />(20) <br />365 <br />*If EHS, amounts must be in lbs AVG DAILY AMT (24) <br />ON SITE 180 <br />LARGEST <br />CONTAINER <br />(21 <br />2.5 GAL <br />ANNUAL WASTE AMT (25) N/A <br />STORAGE <br />(26)❑ABOVE <br />GROUND TANK <br />[]CAN ❑BOX []TAN <br />CONTAINER <br />❑ UNDER GROUND TANK <br />❑ CARBOY ❑ CYLINDER ❑ RAI <br />❑ TANK INSIDE BUILDING <br />❑ SILO ❑ GLASS BOTTLE ❑ Othc <br />❑ STEEL DRUM <br />❑ FIBER DRUM ® PLASTIC BOTTLE, <br />STORAGE (27) ®AMBIENT []ABOVE AMBIENT ❑BELOW AMBI <br />PRESSURE <br />STORAGE (28) INAMBIENT ❑ ABOVE AMBIENT ❑ BELOW AMBIENT ❑ CRYOGENIC <br />TEMPERATURE <br />(29) %,WT ('40114A7.ARnnTTC rrvapn jpw (31) RHC tl'M rAIZA <br />20.9 METHYLPARATHION <br />®YES ❑N <br />298.00-0 <br />❑YES ❑N <br />❑YES ❑N <br />❑YES ❑N <br />❑YES ❑N <br />ADDITIONAL LOCALLY COLLECTED INFORMATION: (33) UNITED NATIONS ID# (DOT) 3018 <br />(34) WHAT IS MATERIAL RETAIL SALES <br />USED FOR? <br />DATE REC'D: 12/14/01 iFor Official Use Only: 0 C 0 R 0 S SJC 12/99 <br />