Laserfiche WebLink
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 20I rCAL LOCATION CONFIDENTIAL EPCRA 202 <br /> RETAIL SHELVES DYES❑NO <br /> FACILITY ID# I �p#RID;fired by `�1 /A /A /A /A 203/204 <br /> E. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) ❑YES IN NO 206 <br /> BRAKE FLUE) If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHS ❑YES ®NO 208 <br /> BRAKE FLUID <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 /> CY E(Check US MATE <br /> A eERIAly) 3 a.PURE H b.MIXTURE p c.WASTE 211 RADIOACTIVE❑YES 10 NO 212 CURIES N/A. 213 <br /> PHYSICAL STATE [3 SOLID N LIQUID [3 GAS 214 LARGEST CONTAINER 215 <br /> (Check one item only) 1 <br /> FED HAZARD CATEGORIES ❑FIRE ❑REACTIVE 10 PRESSURE RELEASE 19 ACUTE HEALTH ❑CHRONIC HEALTH 216 <br /> (Check all that apply) <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 ANNUAL WASTE AMOUNT 21rN/A E WASTE CODE 220 <br /> 11 20 N/A <br /> UNITS* N GAL ❑CU FT ❑LBS ❑TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only *If EHS,amount must be in pounds. 36S <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 ❑CYLINDER ❑OTHER 223 <br /> STORAGE PRESSURE 10 AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE IN AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT or mixture or waste onl ERS" CAS# <br /> >1 226 ETHEXYTRIGLICOL 227 ❑YES ®NO 228 112-50-5 229 <br /> >1 230 METHOZTRIGLYCOL 231 ❑YES ONO 232 112-35-6 233 <br /> 0-8 234 DIETHYLENE GLYCOL 235 ❑YES N NO 236 11146-6 237 <br /> 238 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) NFPA 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? RETAIL SALES <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />