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UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/14/2009-04:20:09 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 rCAL LOCATION CONFIDENTIAL EPCRA 202 <br /> RETAIL SHELVES 0 YES®NO <br /> FACILITY ID# !J=P <br /> b III J#`u /A /A /A /A 203/204 <br /> H. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) ❑YES 19 NO 206 <br /> PAINT If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 Ffis ❑YES ®NO 208 <br /> PAINT <br /> CAS# 209 <br /> MIXTURE *If ENS 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• ®b.MIXTURE O c.WASTE 211 RADIOACTIVE O YES ®NO 212 CURDS N/A 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE ❑SOLID ®LIQUID ❑GAS 214 LARGEST CONTAINER 21 <br /> (Check one item only) 12 OZ <br /> (Check ��D CATEGORIES ®FIRE ❑REACTIVE ❑PRESSURE RELEASE ®ACUTE HEALTH ❑CHRONIC HEALTH 216 <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 ANNUAL WASTE AMOUNT 219STATE WASTE CODE 220 <br /> 5 15 I N/A N/A <br /> UNITS* 11 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 ❑ABOVE GROUND TANK ❑CARBOY ❑GLASS BOTTLE ❑Other... <br /> CONTAINER ❑UNDER GROUND TANK ❑SILO ❑PLASTIC BOTTLE <br /> ❑TANK INSIDE BUILDING ❑FIBER DRUM ❑TOTE BIN <br /> ❑STEEL DRUM ❑BAG ❑TANK WAGON <br /> ❑PLASTIC/NONMETALLIC DRUM ❑BOX ❑RAIL CAR <br /> N CAN ❑CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE N AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %wr HAZARDOUS COMPONENT mixture or waste onl EHS CAS# <br /> 35-40 226 ACETONE 227 ❑YES N NO 228 67-64-1 229 <br /> 0-3 230 DIACETONE ALCOHOL 231 ❑YES IN NO 232 123-42-2 233 <br /> 5-10 234 METHY ISOBUTYL METONE 235 ❑YES ®NO 236 108-10-1 237 <br /> 238 239 ❑YES ❑NO 240 241 <br /> 242 243 ❑YES ❑NO 24.4 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS IDN(DOT) NFPA a� 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? RETAIL SALES <br /> UPCF(Rev.12/2007) If EPCRA,Please Sign Here <br />