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California Hazardous Werials Inventory Form - Chemical &cription <br /> PAGE(2) = OF(3) <br /> BUSINESS NAME (4) LPC PACKAGING INC (1395 REPORT) <br /> CHEMICAL LOCATION(S)(5)MIDDLE OF WAREHOUSE <br /> MAP#(6)/ GRID#(7) E-4 F-4 NIA NIA NIA <br /> CHEMICAL NAME (8)115-15-15 TRADE SECRET (11) ❑YES ONE] Tra <br /> COMMON NAME (9) TRIPLE 15 *EHS(12) ❑YES ®NO <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) 5 SEPERATE NUMBERS(SEE BELOW) ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE (13) <br /> HAZARD LEAVE BLANK <br /> CATEGORIES <br /> TYPE (14) ❑PURE ®MIXTURE [:]WASTE RADIOACTIVE(15) ❑YES ®NO (16) NIA <br /> PHYSICAL STATE(17)IN SOLID []LIQUID ❑GAS CURIES <br /> FED HAZARD ❑FIRE ❑REACTIVE ❑PRESSURE RELEASE ❑ACUTE HEALTH ❑CHRONIC HEALTH <br /> CATEGORIES (18) <br /> STATE WASTE (19) UNITS*(22) ❑GAL ❑LBS <br /> CODE NIA ID CU FT ®TONS MAX DAILY AMT(23)SOQ <br /> ON SITE <br /> DAYS ON SITE (20) *If EHS, amounts must be in lbs AVG DAILY AMT(24) <br /> 365 ON SITE 250 <br /> LARGEST (21)50# BAG ANNUAL-WASTE AMT(25) N/A <br /> CONTAINER <br /> ::1 1 :1 <br /> STORAGE (26)❑ABOVE GROUND TANK []CAN ❑BOX ❑TANIN <br /> CONTAINER ❑UNDER GROUND TANK []CARBOY ❑CYLINDER ❑RAIL <br /> ❑TANK INSIDE BUILDING ❑SILO ❑GLASS BOTTLE ❑OTH <br /> ❑STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE ❑Other <br /> ❑PLASTIC/NONMETALLIC DRUM ®BAG ❑TOTE BIN <br /> STORAGE (27) ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) ®AMBIENT [:]ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC <br /> TEMPERATURE <br /> (29)%nWT 30 HAZARDOUS COMPONENT (3 1)EHS 32 CAS# <br /> 20 AMMONIUM NITRATE JOYES ®N 6484-52-2 <br /> 20 CALCIUM PHOSPHATE ❑YES ON 7757-93-9 <br /> 2 0 MONOAMMONIUM PHOSPHATE ❑YES ON 7722-76-1 <br /> 20 DIAMMONIUM PHOSHATE ❑YES ®N 7783-28-0 <br /> 20ASSIUM SULFATE ❑YES ®N 7778-80-5 <br /> POT <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) N/A <br /> (34)WHAT IS MATERIAL Fertilizer <br /> USED FOR? <br /> DATE REC'D: 12/22/05 For Official Use Only: ❑C ❑R ❑S SJC 12/99 <br />