Laserfiche WebLink
•W a"il�y '�d.: .. .,.d Y;2S- L :h i . - hmd S < __ _N:�'(�`iE - - Y4 <br /> _ _ t",.t •i g •.ls, x...' e I mss.... <br /> -'• - 'T - .. c .-r �x .e.' <br /> 'YY�m <br /> T Y <br /> Cabfornia Hazardous a Inventory Reporting Form - emical Dessriptioa Page <br /> (Y) D ®DELETEREVISE 1998 PAGE(2) ry OF(3) <br /> BUSINESS NAME (4) n <br /> CHEMICAL LOCATION(S)(5) <br /> � <br /> <br /> <br /> CHEMICAL NAME (8) TRADE SECRET(11) �Y N <br /> COMMON NAME (9) t�riC _ Sv e,i U����J�� *EHS (12) ❑YZN <br /> CAS # �r 10 *IF EHS BOX IS "Y" <br /> ( <br /> d D —6/� ALL AMOUNTS MUST BE IN LBS <br /> FIRE CODE. (13) LEAVE BLANK <br /> HAZARD CLASS <br /> TYPE (14) ❑PUREaEMIXTURE ®WASTE RADIOACTIVE(15) ®Y (16) <br /> PHYSICAL STATE (17)LE]SOLID LIQUID ®GAS CURIES <br /> FED HAZARD <br /> CATEGORIES (18)LWFIRE ❑REk=T E ❑PRESSURE RELEASE AaM HEALTH CHRONIC HEALTH <br /> STATE WASTE (19) UNITS*(22) E]GAL, ® CU FT MAX DAILY ABMT(23) <br /> CODE :1 [_] TONS <br /> LBS ON-SITE L�-a o 0 <br /> ® ® <br /> DAYS ON SITE (20) AVG DAILY AMT(24) <br /> 36E *If EHS, amounts must be in lbs ON-SITE 300 0 <br /> LARGEST (Z 1 ANNUAL WASTE AMT(25) <br /> CONTAINER LY-000 <br /> STORAGE (26) ❑ABOVE GROUND TANK ❑ CAN ❑ BOX ❑TANK WAGON <br /> CON I'AIIvER ®UNDER GROUND TANK ❑CARBOY ® CYLINDER F-1 RAIL CAR <br /> ❑TANK INSIDE BUILDING ❑ SILO ❑ GLASS BOTTLE ❑-------------------- <br /> ❑STEEL DRUM ❑FIBER DRUM ® PLASTIC BOTTLE <br /> ®PLASTIC/NONMETALLIC DRUM ® BAG ® TOTE BIN <br /> STORAGE (27) AMBIENT 0 ABOVE AMBIENT ❑BELOW AMBIENT <br /> PRESSURE LJ <br /> STORAGE (28) AatiIBIENT ❑ABOVE AMBIENT [:]BELOW AMBIENT ® CRYOGENIC <br /> TEMPERATURE LN <br /> (29)%AWT (30)HAZARDOUS COMPONENT (3 1)EHS (32) CASK <br /> ❑Y [:]N <br /> [—® <br /> ®Y El <br /> • , Loy MN t ® <br /> ADDITIONAL LOCALLY COLLECTED INFORMATION: (33)Li=NATIONS ID#(DOT) <br /> (34)WHAT IS MATERIALtlj �D13/� <br /> USED FOR? <br /> For Official Use Only: ❑ C ❑ R ❑ S SIC 12/97 <br />