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UNIFIED PROGRAM CONSOLIDATED FORM <br /> RAMRDOUS MATERIALS <br /> HAZARDOUS MATERIALS INVENTORY-CHEMICAL DESCRIPTION <br /> 10/14/2009-02:20:14 P <br /> Page of <br /> I. FACILITY INFORMATION <br /> BUSINESS NAME(Same as FACILITY NAME or DBA-Doing Business As) 3 <br /> SEARS#1288/6791 <br /> CHEMICAL LOCATION 201 7CAL LOCATION CONFIDENTIAL EPCRA 202 <br /> ❑X YES❑NO <br /> FACILITY ID# I MAP# RID# 2031204 <br /> Required by <br /> II. CHEMICAL INFORMATION <br /> CHEMICAL NAME 205 TRADE SECRET(11) ❑YES 0 NO . 206 <br /> USED MOTOR OIL <br /> If Subject to EPCRA,refer to instructions <br /> COMMON NAME 207 208 <br /> USED MOTOR OIL EHS* ❑YES M NO <br /> CAS# 209 <br /> MIXTURE *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 MATERIAL0 a PURE M b.MIXTURE N c.WASTE 211 RADIOACTIVE 13 YES 0 NO 212 CURIES 213 <br /> TYPE(Check one item only) <br /> PHYSICAL STATE 13 SOLID 0 LIQUID ❑GAS 214 LARGEST CONTAINER 21 <br /> (Check one item only) 5®0 <br /> FED HAZARD CATEGORIES 19 FIRE .❑REACTIVE ❑PRESSURE RELEASE M ACUTE HEALTH216 <br /> (Check all that apply) ❑CHRONIC I�ALTH <br /> AVERAGE DAILY AMOUNT 217 MAXIMUM DAILY AMOUNT 21 BIANNUAL WASTE AMOUNT 219 STATE WASTE CODE 220 <br /> 250 S00 19NO 221 <br /> UNITS* ®GAL ❑CU IT ❑LBS ❑TONS 221 1 DAYS ON SITE 222 <br /> (Check on item only *If ERS,amount must be in pounds. 365 . <br /> STORAGE 19 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 /> ❑CAN p CYLINDER ❑OTHER <br /> 223 <br /> STORAGE PRESSURE 19 AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT 224 <br /> STORAGE TEMPERATURE ®AMBIENT ❑ABOVE AMBIENT ❑BELOW AMBIENT ❑CRYOGENIC 225 <br /> %WT HAZARDOUS COMPONENT(For mixture or waste only EHS CAS# <br /> 100 226 WASTE PETROLEUM HYDROCARBONS 227 ❑YES ONO 228 MIXTURE 229 <br /> 230 231 ❑YES ❑NO 232 233 <br /> 234 235 El YES [3 NO 236 237 <br /> 238 239 ❑YES [E031 NO 240 241 <br /> 242 243 ❑YES ❑NO 244 245 <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)UNITED NATIONS ID#(DOT) 1270 246 <br /> (34)WHAT IS MATERIAL <br /> USED FOR? AUTOMOTIVE MAINTENANCE-SENT OFFSITE FOR RECYCLING <br /> I <br /> UPCF(Rev,12/2007) If EPCRA,Please Sign Here <br /> i <br /> i <br /> i <br /> i <br />