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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/14/2009-02:11:24 P <br /> Page off <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 rCAL LOCATION CONFIDENTIAL EPCRA 202 <br /> SERVICE AREA-COMPRESSOR ROOM YES®NO <br /> FACILITY ID# 1 MAPeGRID#1/E7 203/204 <br /> Required by SJ <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) p YES ®NO 206 <br /> WASTE,ETHYLENE GLYCOL If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHp YES ®NO 208 <br /> S° <br /> WASTE,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 COPA) 210 <br /> LEAVE BLANK <br /> TYPE HAZARDOUS <br /> DOU oM MATERIAL <br /> 0 a.PURE p b.MIXTURE ®c.WASTE 211 RADIOACTIVE❑YES 19 NO 212 CURIES N/A 213 <br /> (ChecPHYSICAL STATE p SOLID 10 LIQUID ❑GAS 214 LARGEST CONTAINER 215 <br /> (Check one item only) 275 <br /> (FED k all <br /> HAZARD CATEGORIES 01 FIRE ❑REACTIVE p PRESSURE RELEASE IN ACUTE HEALTH ❑CHRONIC HEALTH 216 <br /> that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 ANNUAL WASTE AMOUNT219 STATE WASTE CODE 220 <br /> I80 27S 1320 342 <br /> UNITS* ®GAL ❑CU Fr ❑LBS ❑TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only •If EHS,amount must be in pounds. 365 <br /> STORAGE 10 ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER p UNDER GROUND TANK O SILO ❑PLASTIC BOTTLE <br /> ❑TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM ❑BAG ❑TANK WAGON <br /> p PLASTIC/NONMETALLIC DRUM ❑BOX p RAIL CAR <br /> O CAN p CYLINDER p OTHER <br /> 223 <br /> STORAGE PRESSURE 19 AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE N AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT For mixture or waste onl EUS CAS# <br /> 80-95 226 ethylene glycol 227 ❑YES ONO 228.107-21-1 229 <br /> 0-8 230 diethylene glycol 231 ❑YES ONO 232 11146-6 233 <br /> 234 235 ❑YES []No 236 237 <br /> 238 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1142 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? lCoolant removed during service operations. <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />