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California Hazardous Serials Inventory Form • Chemical locription <br /> PAGE(2) OF(3) <br /> BUSINESS NAME (4) WAYNE MOTOR COMPANY <br /> CHEMICAL LOCATIONS)(5) <br /> TBD TBD <br /> CHEMICAL NAME (8) WASTE OIL TRADE SECRET(11) ❑YES ®NO <br /> COMMON NAME (9) WASTE OIL *EHS (12) ❑YES ®NO <br /> *IF EHS BOX IS"Y" <br /> CAS # (10) N/A 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) <br /> PHYSICAL STATE(17) ❑SOLID ®LIQUID []GAS CURIES <br /> FED HAZARD <br /> CATEGORIES (18) ®FIRE ❑REACTIVE [IRE <br /> PSSURE RELEASE ®ACUTE HEALTH ®CHRONIC HEALTH <br /> STATE WASTE (19) UNITS*(22) ®GAL ❑LBSMAX DAILY AMT(23) <br /> ❑ 165 <br /> CODE 221 CU FT ❑TONS ON SITE <br /> DAYS ON SITE (20) 365 *If EHS, amounts must be in lbs AVG DAILY AMT(24) 8 5 <br /> ON SITE <br /> LARGEST (21)5 5 ANNUAL WASTE AMT(25) 16 5 <br /> CONTAINER <br /> STORAGE (26)❑ABOVE GROUND TANK ❑CAN ❑BOX ❑TAN <br /> CONTAINER []UNDER GROUND TANK []CARBOY ❑CYLINDER ❑RAIL <br /> ❑TANK INSIDE BUILDING ❑SILO ❑GLASS BOTTLE ❑OTH <br /> IN STEEL DRUM ❑FIBER DRUM ❑PLASTIC BOTTLE ❑Other <br /> ❑PLASTIC/NONMETALLIC DRUM []BAG ❑TOTE BIN <br /> STORAGE (27)IDI AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE <br /> STORAGE (28) ®AMBIENT []ABOVE AMBIENT []BELOW AMBIENT ❑CRYOGENIC <br /> TEMPERATURE <br /> (29)%aWT 30 HAZARDOUS COMPONENT (3 1)EHS 32 CAS# <br /> N/A []YES ❑N <br /> N/A ❑YES ❑N <br /> N/A EY <br /> YES ❑N <br /> N/A 11 =I[E]YES ❑N <br /> N/A ❑YES ❑N <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1270 <br /> (34)WHAT IS MATERIAL WASTE PRODUCT <br /> USED FOR? <br /> DATE REC'D: 5/11/07 iFor Official Use Only: H C ❑ R ❑S SIC 12/99 <br />