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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/14/2009-04:20:08 P <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 CAL LOCATION CONFIDENTIAL EPCRA 202 <br /> RETAIL SHELVES ®YES❑NO <br /> FACILITY IDA 1 MAA1GRID# 203/204 <br /> Required by SJ <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) ❑YES ®NO 206 <br /> HFC 134A If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHS ❑YES 10 NO 208 <br /> HFC 134A <br /> CASA 209 <br /> 811-97-2 *If ERS is "Yes",all amounts must be in lbs. <br /> FIRE CODE HAZARD CLASSES(Complete if required by CUPA) 210 <br /> LEAVE BLANK <br /> HAZARDOUS MATERIAL ®a.PURE p b.MIXTURE O c.WASTE 211 RADIOACTIVE❑YES ®NO 212 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE ❑SOLID ❑LIQUID ®GAS 214 LARGEST CONTAINER 215 <br /> (Check one item Drily) � <br /> FED HAZARD CATEGORIES ❑FIRE ❑REACTIVE ®PRESSURE RELEASE ❑ACUTE HEALTH ❑CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 120 180 N/A I N/A <br /> UNITS* ❑GAL ❑CU F1' N LBS ❑TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only *If ERS,amount must be in pounds. 365 <br /> STORAGE ❑ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO N PLASTIC BOTTLE <br /> ❑TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM ❑BAG ❑TANK WAGON <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BOX ❑RAIL CAR <br /> ❑CAN H CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE ❑AMBIENT ®ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT or mixture or waste only ERSA A <br /> 100 226 1,1,1,2 TETRAFLOUROETHANE 227 ❑YES ®NO 228 811-97-2 229 <br /> 230 231 ❑YES ❑NO 232 233 <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 IDA(DOT) NFPA^_ 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? IRETAIL SALES <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />