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UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY — CHEMICAL DESCRIPTI(one page ONnat perbuildin or area <br /> zoo Page_of_ <br /> []ADD ❑DELETE ❑REVISE <br /> I. FACILITY INFORMATION 3 <br /> BUSINESS NAME(Same as FACILITY NAME or DBA—Doing Business As) <br /> Beacon Station#3492 zo1 CHEMICAL LOCATION CONFIDENTIAL 2oz <br /> CHEMIC AL LOCATION EPCRA <br /> [I ES ® NO 204 <br /> 1 MAP#(option'$) 203 GRID#(options$) <br /> FACILITY ID# <br /> II. CHEMICAL INFORMATION 206 <br /> zos TRADE SECRET El Yes N No <br /> CHEMICAL NAME If subject to EPCRA,refer to instructions <br /> Unleaded Gasoline 207 zoa <br /> COMMON NAMEYes N No <br /> Gas 209 <br /> CAS# If EHS is"Yes",all amounts below must be in lbs. <br /> 8006-61-9 2t0 <br /> FIRE CODE HAZARD CLASSES(Complete if required by COPA) <br /> 3-FLLQl27 213 <br /> HAZARDOUS MATERIAL 211 RADIOACTIVE ❑Yes N No 212 CURIES <br /> TYPE(Check one item only) ❑a.PURE N b.MIXTURE ❑c.WASTE 215 <br /> PHYSICAL STATE214 LARGEST CONTAINER <br /> (Check one Item only) ❑a.SOLID N b. LIQUID [Ic.GAS 216 <br /> FED HAZARD CATEGORIES <br /> TH <br /> (Check all that apply) N a. FIRE ❑b. REACTIVE ❑ c.PRESSURE RELEASE N d. ACUTE HEALTH N e. CHRONIC HEAL <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT <br /> 216 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> z21 DAYS ON SITE: 222 <br /> UNITS' N a.GALLONS ❑b. CUBIC FEET ❑ c.POUNDS ❑d.TONS 365 <br /> Check one item on] 'If EHS,amount must be in bounds. <br /> STORAGE <br /> CONTAINER [I a,ABOVE GROUND TANK ❑e.PLASTICINONMETALLIC DRUM O 1 <br /> N o UNDERGROUND TANK ❑f.CAN BIABGR DRUM O n . PLASTIC BOTTLE [3 m.GLASS BOTTLE 0 9. RAILCAR <br /> OTHER <br /> ❑o. TOTE BIN <br /> El c,TANK INSIDE BUILDING ❑g.CARBOY k. 223 <br /> ❑ 1. CYLINDER [3p., TANK WAGON <br /> [3 d. STEEL DRUM ❑h.SILO 224 <br /> STORAGE PRESSURE N a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT <br /> 225 <br /> STORAGE TEMPERATURE N a. AMBIENT [Ib. ABOVE AMBIENT ❑ c. BELOW AMBIENT ❑d. CRYOGENIC <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only) EHS CAS# <br /> 1 85-100 226 Petroleum Hydrocarbons 227 Cl Yes N No 228 Mixture 229 <br /> 231 C]Yes N No 232 1634-04-4 233 <br /> 2 0-15 230 MTBE <br /> 235 E]Yes N No 236 71-43-2 237 <br /> s >.01 234 Benzene <br /> 239 ❑Yes ❑ No 240 241 <br /> 4 236 <br /> 243 ❑Yes ❑ No 244 245 <br /> 5 242 <br /> rdous components are present at greater than 1%by weight in...<arcinogenic,or 0.1%by weight If carcinogenic,attach additional sheets of paper capturing the required <br /> H more haza246 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION <br /> United Nations ID# (DOT) 1203 <br /> What is Material Used For? Retail Gas Sales If EPCRA,Please Sign Here <br /> OES Form 27" <br /> UPCF(1199) <br />