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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/14/2009-04:20:09 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 rCAL LOCATION CONFIDENTIAL EPCRA 202 <br /> RETAIL SHELVES YES[:]NO <br /> FACILITY ID# 1 MAPed by Sj` 203/204 <br /> Requited by SJ <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) ❑YES N NO 206 <br /> GAS ADDITIVES If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 EHS YES ®NO 208 <br /> GAS ADDITIVES <br /> CAS# 209 <br /> NIDCE *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 /> TYPEHAZARDOUS <br /> ARDO k rnMATERIAL <br /> u i TERIAem ❑a.PURE ®b.MIXTURE O e.WASTE 211 RADIOACTIVE❑YES IN NO 212 CURIES N/A 213 <br /> PHYSICAL STATE ®SOLID ®LIQUID ❑GAS 214 LARGEST CONTAINER 21 <br /> (Check one item only) 16 OZ <br /> (FED k aIHA l thatapply)CATEGORIES ®FIRE [3 REACTIVE ❑PRESSURE RELEASE H ACUTE HEALTH [3 CHRONIC HEALTH 216 <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 2I ANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 4 12 N/A N/A <br /> UNITS* ®GAL ❑CU FT ❑LBS ❑TONS 221 DAYS ON SITE 222 <br /> (Check on item only *If EHS,amount must be in pounds. 136S <br /> STORAGE ❑ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO ®PLASTIC BOTTLE <br /> 0 TANK INSIDE BUILDING ❑FIBER DRUM: ❑TOTE BIN <br /> ❑STEEL DRUM ❑BAG p TANK WAGON <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BOX ❑RAIL CAR <br /> ❑CAN ❑CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE O AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT For mixture or waste onl ERS CAS# <br /> 50-80 226 KEROSENE 227 ❑YES ®NO 228 8008-20-6 229 <br /> 5-20 230 LIGHT AROMATIC SOLVENT 231 ❑YES ®NO 232 64742-95-6 233 <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) N PA 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? IRETAIL SALES <br /> UPCF(Rev.1212007) If EPCRA,Please Sign Here <br />