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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 04/23/2010- 12:44:24 PM <br /> Page of <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> PEP BOYS #711 <br /> CHEMICAL LOCATION 201 HEMICAL LOCATION CONFIDENTIAL EPCRA 202 <br /> RETAIL AREA [X]YES[—]NO <br /> FACILITY IDS I MA # <br /> SJ 203/204 <br /> Required by /D6 <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) 0 YES 119 NO 206 <br /> ETHYLENE GLYCOL If subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHS Q YES H NO 208 <br /> ANTI-FREEZE/COOLANT <br /> CAS# 209 <br /> MIXTURE *If EHS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HAZARD ck Soba it�y) p a PURE ®b.MISTURE a c.WASTE 211 RADIOACTIVE 0 YES H NO 212 CURIES N/A 213 <br /> TYPE(ChePHYSICAL STATE 0 SOLID H LIQUID 0 GAS 214 LARGEST CONTAINER 21 <br /> (Check one item only) 1 <br /> FED HHA�IZHAZARDthataCAT CATEGORIES ®FIRE O REACTIVE ®PRESSURE RELEASE N ACUTE HEALTH [3 CHRONIC HEALTH 216 <br /> (CheckAVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 ANNUAL WASTE AMOUNT 2191 STATE WASTE CODE 220 <br /> 200 350 N/A N/A <br /> UNITS* H GAL 0 CU FT 13 LBS 17 TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only s If EHS,amount must be in pounds. 365 <br /> STORAGE 0 ABOVE GROUND TANK O CARBOY 0 GLASS BOTTLE 0 Other... <br /> CONTAINER 0 UNDER GROUND TANK O SILO H PLASTIC BOTTLE <br /> 0 TANK INSIDE BUILDING O FIBER DRUM 0 TOTE BIN <br /> O STEEL DRUM 0 BAG 0 TANK WAGON <br /> 0 PLASTIC/NONMETALLIC DRUM O BOX 13 RAIL CAR <br /> O CAN O CYLINDER 0 OTHER <br /> 223 <br /> STORAGE PRESSURE H AMBIENT 0 ABOVE AMBIENT 0 BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE H AMBIENT 0 ABOVE AMBIENT 0 BELOW AMBIENT 0 CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT or mixture or waste only ERS CAS# <br /> 80-95 226 Ethylene Glycol 227 0 YES H NO 228 107-21-1 229 <br /> 0-8 230 Diethylene Glycol 231 0 YES N NO 232 111-46-6 233 <br /> 234 235 0 YES ONO 236 237 <br /> 238 239 0 YES 0 NO 240 241 <br /> 242 243 0 YES 0 NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1142 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? IPackaged for retail sale. <br /> UPCF(Rev.1212007) If EPCRA,Please Sign Here <br />