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HomeMy WebLinkAboutBUSINESS PLAN (2) Hazardous Materials/HazardoUs Waste Unified Permit ~ CONDITIONS OF PI=~MIT Obi Fl l:: ¥1= l:l $1:: $1Dl: This 0ermit is issued for the followina: [] H=-ardous Materials Plan 13 Underground Storage of Hazardous Materials Permit ID #:: 015-000-001926 13 Risk Management Program S PA R K A U T O R E PA I R 13 H~,-ardous Waste On-Site Treatment LOCATION: 529 E 19TH ST Issued by: Bakersfield Fire Department . ~ ~ --,'9~ ,/~/?. ~ 1715 Chester Ave., 3rd Floor . L~pU,a~y,m~i ,s~,,e o~e " Bakersfield, CA 93301 OfficeofEv~Servi¢~ ~ Voice (661) 326-3979 FAX (661) 326-0576 'Ex?;UmionDate: 'June :30.. 2003 CITY of BAKERSFIELD ~'RADE SECRETS BUSINESS NAME: OWNER NAME: ....... NAME OF T~ _FACILITY: ...... LOCATION: ADDRESS: STANDARD IND. CLASS CODE CITY, ZIP: CITY, ZIP: DUN AND BRADSTREET NUMBER PHONE ~: PHON~ ~: _ _ - - ~ ~ ~U~O~ ~ ~0~ COD~ C~e C~e ~t ~t Est Un~ts m Site I~ ~l T~ ~ St~ tn F~tllty~ ~ Inst~ti~ .... 1 1 ..... ............. i ........... 1 .......... l_.L_ I I I I .... J. ........... (c~ 411 t~t aaply) .......... H~lth of P~ ~lth ~t P~ical ~d HflJth HIzIK C.l.S. ~k iH t~t ~pply) H~lth of P~ ~lth ~t 13 (C~k ii1 t~t apply) '~-~ -- -- -- r--~ ~t 12 Nm&C.A.S. ~ --~ Fire Hazard ~ ~ R~ctivtty ~ ~ ~le~ [ ~ ~d~ Reline L--J I~Jate - . ..... Health of P~c~l ~ Hfllth bza~ C.A.S. (C~k 411 t~t i~ly) ~--] Fire Hazard ~--~ ~ctivity ~--a ~la~ ~--J ~dK Release ~_a I~tete Health of Pr~suee flealth ~NE~GENCY C~TACTS I1 Cer~ificat*m /Read and s~Kn after compJet~n~ a]] sectJons) I certify ~der ~lty of lee t~t I ~ve ~rsmally exee~n~ and aa faeJlJir eJth t~ JnforNtJm su~Jtt~ tn thJs ~ ell ettK~ ~ts. ~ t~t ~s~ m ~ ~n~J~ of t~e t~tvJ~ls eH~sJble f~,r obta~nJn9 t~ mf~tJm. I ~lJeve t~t t~ su~JttK Jnfoe~t*m Js t~. accurate, and c~atete. Si~R)EG;i ...................................................... ~Ti'Si~Ri(1 ............................. KBF-7171 CORRECTION NOTICE BAKERSFIELD FIRE DEPARTMENT N° 9 1 3 Location ~'-~'~ ~'-" //? ~ Sub Div. Blk .... ~t. You are hereby required to make the following corrections at the above l~ation: Cot. ~o O~ ~ ~ ~P. ~--lO:~ Completion Date fo,' Corrections. ~/~/~':~ Inspector 325-3979 SPARK AUTO REPAIR SiteID: 215-000-001926 I ,iRI -'.CEiVED BusPhone: (661) 328-9477 Manager : 1~ J~N21 Z000 / Map : 103 CommHaz : Low Location: 529 E 19TH ST City : BAKERSFIELD Grid: 29C FacUnits: 1 AOV: CommCode: BAKERSFIELD STATION 02 SIC Code: EPA Numb: DunnBrad: Emergency Contact / Title Emergency Contact / Title MARGARITA MEDINA / OWNER VICTOR CHAVEZ / EMPLOYEE Business Phone: (661) 328-9477x Business Phone: (661) 328-9477x 24-Hour Phone : (661) 836-1255x 24-Hour Phone : (661) 845-0161x Pager Phone : (661) - x Pager Phone : ( ) - x Hazmat Hazards: Fire DelHlth Contact : Phone: (661) 328-9477x MailAddr: 529 E 19TH ST State: CA City : BAKERSFIELD Zip : 93305 Owner MARGARITA MEDINA Phone: (661) 836-1255x Address : 1217 MERIDITH DR State: CA City : BAKERSFIELD Zip : 93304 Period : to TotalASTs: = Gal Preparer: TotalUSTs: = Gal Certif'd: RSs: No Emergency Directives: I, ~0~ ~'~.-'-{ ..~/"~(.r,.J Do hereby certify that i have (Type or p~n! name) reviewed the a~ached h~ard~s materials ma~":a~4e- ment plan fo~~~~d that it alon~ (~ of ~e~) any correaions constitute a complete and correa~ man- agement plan for my facili~. -1- 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 ~ Hazmat Inventory By Facility Unit ~ Alphabetical Order Fixed Containers at Site ISpecHazlEPA HazardsI Frm DailyMax Unit MCP Hazmat Common Name... SOLVENT F DH L 30.00 GAL Mod WASTE ANTIFREEZE F DH L 55.00 GAL Low WASTE OIL F DH L 110.00 GAL Low WASTE TRANSMISSION FLUID F DH L 55.00 GAL Low -2- 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 ~ Inventory Item 0004 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME SOLVENT Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE NE CORNER OF SHOP BLDG CAS# F STATE ~ TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Pure Ambient Ambient OTHER- SPECIFY AMOUNTS AT THIS LOCATION Largest Container I Daily Maximum Daily Average 30.00 GAL 30.00 GAL 30.00 GAL I HAZARDOUS COMPONENTS 100.00 Naphtha N 8030306 HAZARD ASSESSMENTS I [ ITSecret[ RSIBioHazl Radioactive/Amount I EPA Hazards NFPA USDOT# MCP No No No No/ Curies F DH / / / Mod = Inventory Item 0002 Facility Unit: Fixed Containers at Site ~ -- COMMON N~E / CHEMICAL N~E WASTE ~TIFREEZE Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE SE COMER OF BLDG CAS# 107-21-1 F STATE = TYPE PRESSURE TEMPE~TURE CONTAINER TYPE /Liquid ~Waste I Ambient IAmbient IDR~/BARREL-METMLIC ~O~TS AT THIS LOCATION Largest Container Daily Maximum Daily Average 55.00 GM 55.00 GM 55.00 GM 30.00 Ethylene Glycol N 107211 HAZARD ASSESSMENTS I I 'TSecret' RS'BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP linc NoI No No/ Curies F DH / / / Low -3- 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 ~ Inventory Item 0001 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME WASTE OIL Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE SE CORNER OF SHOP CAS# 221 F STATE TYPE PRESSURE ITEMPERATURE I CONTAINER TYPE I Ambient Waste Ambient Liquid DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 55.00 GAL 110.00 GAL I 55.00 GAL HAZARDOUS COMPONENTS %Wt. I ~S CAS# 100.00 Waste Oil, Petroleum Based N 0 HAZARD ASSESSMENTS TSecretl RSIBioHazl Radioactive/Amount I EPA Hazards NFPA I USDOT# I MCP No No No No/ Curies F DH / / / Low ---- Inventory Item 0003 Facility Unit: Fixed Containers at Site -- COMMON NAME / CHEMICAL NAME ~ WASTE TRANSMISSION FLUID I Days On Site 365 Location within this Facility Unit Map: Grid: INSIDE SE CORNER OF SHOP BLDG CAS# 221 FSTATE TYPE PRESSURE i TEMPERATURE CONTAINER TYPE Liquid Waste Ambient Ambient DRUM/BARREL-METALLIC AMOUNTS AT THIS LOCATION Largest Container Daily Maximum I Daily Average 55.00 GAL 55.00 GALI 55.00 GAL HAZARDOUS COMPONENTS 100.00 Transmission Fluid (Petroleum-Based) N HAZARD ASSESSMENTS TSecret NoRSIBioHaz Radioactive/Amount I EPA HazardsI NFPA USDOT# I MCP No No No/ Curies F DH / / / Low _~- 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 Fast Format F Notif./Evacuation/Medical Overall Site Agency Notification -- Employee Notif./Evacuation ~ Public Notif./Evacuation V~ ~~.~/ Emergency Medical Plan 5 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 Fast Format ~ Mitigation/Prevent/Abatemt Overall Site Release Prevention -- Release Containment Clean Up Other Resource Activation 6 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 Fast Format Site Emergency Factors Overall Site Special Hazards Ut ~, %it~y~ Shut-Of~g,~ Building Occupancy Level -7- 01/21/2000 SPARK AUTO REPAIR SiteID: 215-000-001926 Fast Format ~ Training Overall Site Employe~ Training ~© ~ Page 2 ~ Held for Future Use Held for Future Use -8- 01/21/2000 , CITY OF BAKERSFIELD FIRE DEPARTMENT OFFICE OF ENVIRONMENTAL SERVICES UNIFIED PROGRAM INSPECTION CHECKLIST 1715 Chester Ave., 3rd Floor, Bakersfield, CA 93301 FACILITY NAME ,..~{9/:Y~''t~ ~ INSPECTION DATE Section 4: Hazardous Waste Generator Program EPA ID # [] Routine 4~Combined [] Joint Agency [] Multi-Agency [~J Complaint [] Re-inspection OPERATION C /V COMMENTS Hazardous xvaste determination has been made / EPA ID Number (Phone: 916-o_4-1781 to ohtain EPA ID #) did //gl( Authorized for waste treatment and/or storage Reported release, fire. or explosion within 15 days ofoccurance Established or maintains a contingency plan and training ~ gi:~ , Hazardous waste accunaulation time fi-ames ...~.' ~ Containers in good condition and not leaking Containers are compatible with the hazardous waste Containers are kept closed xvhen not in use Weekly inspection of storage area Ignitable/reactive waste located at least 50 feet from property line Secondary containment provided Conducts daily inspection of tanks ~,,/' Used oil not contaminated with other hazardous waste Proper management of lead acid batteries including labels /~ ~ Propel' management of used oil filters t./'~ Transports hazardous ~vaste with completed manifest ~:>/..(~.~>~ ~'~:IC:::~ Sends manifest copies to DTSC Retains manifests lbr 3 years Retains hazardous waste analysis fi)r 3 years Retains copies of used ()il receipts fi)r 3 years ~ Determines if waste is restricted fi'om land disposal c,_r ..... pliance V=Violation ~,~ ~' Inspector: ~/x-fl f A/~5 -. Office of Environmental Services (805)326-3979 Busines,~spon.~ble Party \Vhite - Env. Svcs. Pink - Business Copy CITY OF BAKERSFIELD ~.,~.3,~ . OFFICE OF ENVIRONMENTAL SERVICES 9~'~ 1715 Chester Ave., Bakersfield, CA 93301 (805) 326-397 BUSINESS NAM~ (Same as FACILI~ NAME or DBA- Doing Busings ~) 3 BUSINESS PHONE ~o2 Cl~ 1~ ~ CA I ZIP ~~ DUN & ~06 J SIC CODE 107 B~DSTREET ~ (4 Digit ~) COUN~ OWNER NAME ~ ~~ C/~~ '" ~ OWNER PHONE OWNER MA~UNa ~ ~ ~ ~ t c ~ ~ ADDRESS 113 :;,., .~ -....,...~-, ~_.,..~..~__ ~--~. --~7 114 STATE 115 ZIP ~ I CONTACT NAME ~ CONTACT PHONE 117 CONTACT MAILING ~19 ADDRESS CI~ ~20 STATE 121 ZIP ' NAME ~t~O~ ~ ~~ 123 NAME ~ ~~ ~~ TITLE ~~ 125 TITLE ~' ~'O BUSINESS PHONE ~ ~ ~ ~~ 126 BUSINESS PHONE ~4~ -- ~ ~O 131 24-HOUR PHONE ~4~-- O ~ ~ / ,27 24-HOUR PHONE ,32 PAGER ~ ~ ~ ~-- 4 7~ 128 PAGER ~ 13~ Ce~ifi~aon: Based on my inqui~ of ~ose individuals responsible for ob~ining the information, I ce~i~ under penal~ of law that I have pemonally examined and am familiar with the info~ation submi.ed in this invento~ and believe ~e info~ation is tree, accurate, and ~mplete. SIGNATURE OF O~E~OPE~TOR DATE 134 ~ME OF ~CUME~ PREPARER 135 ~MES OF O~E~OPE~TOR (print) 136 TITLE OF O~E~OPE~TOR 137 0£5 FOI~M 2'7'50 (7/9~5) P:\OES2730.TV4.wDd CITY OF BAKERS LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form I (one form per matedal per building or area) [] ADD [] DELETE [] REVISE 200 Page __ of CHEMICAL NAME t 205 T~DE SECRET D Y~ COM~N NAME 207 EHS* CAS ~ 209 · ~.~E~EHS i~'. ail am~ b~ FIRE ~DE H~RD C~SSES (~plete if r~u~t~ by I~1 fire ~i~ 210 ~PE ~ p PURE ~ m MI~URE ~ w WASTE 211 ~DIOACTIVE ~ Y~ ~ No 2a2 CURIES 213 PHYSICAL STATE s SOUD ~UQU~D D g ~S 2~n ~.~STCOmA~NE. 215 FED H~RD CATEGORIES ~ I FIRE ~ 2 R~CTIVE D 3 PRESSURE REL~SE ~ 4 ACUTE H~LTH ~ 5 CHRONIC H~LTH (~e~ all that apply) 216 UNITS* ~ ga ~L D d cu ~ ~ lb LBS D m TONS 221 DAYS ON S~E 222 · If EHS, am~nt must be in lbs. STOOGE CONTAINER (Check afl that apply) ~ a ABOVEGROUND TANK D e P~STI~ONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS BO~LE D q ~IL ~R 223 ~ b UNDERGROUND TANK D f CAN ~ j BAG ~ n P~STIC BO~LE ~ r OTHER D c T~K INSIDE BUILDING ~ g CARBOY ~ k BOX ~ o TOTE BIN ~d STEEL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a AMBIE~ ~ aa ABOVEAMBIE~ ~ ba BELOW~BIE~ 224 STOOGE TEMPE~TURE ~ a AMBIE~ ~ aa ABOVE ~BIE~ Dba BELOW AMBIE~ ~ c CRYOGENIC 225 1 2~ 227 ~ Y~ ~ No 228 229  230 231 ~ Y~ ~ No 232 233 2~ 235 ~ Y~ ~ No 236 237  238 239 ~ Y~ ~ No 240 241 242 243 ~ Y~ ~ No 244 245 PRINT ~ME & TITLE OF AUTHORIZED COMPANY REPRESENTATIVE SIG~TURE DATE 246 DES FORM 2731 (7198) P:~,OES2731 .TV4.wpd CITY OF BAKERS LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per mate#al per building or area) [] ADD [] DELETE [] REVISE 200 Page __ of __ · · · :. :..,,',' , r:. ., · ' ,~' ,': :? ~ '-~"~/~"~: ':,~ ~ '~. ~>,',.',.:-~,' ':, '~ :','-'~::,: -%~-'"'-~',:.<'". ~"~" '<..'.'?.:×~,?~ ,' :~ ~:!~: ,::~,~:'~!~':.:~:?~!'i~:~,'7:::~2:' :' :"i' ~' ,'' · :' -':. ' ,' . ~:, BUSINESS ~ME (Same as FACILI~ ~ME ~ D~ - D~ng Busin~ ~) 3 205 T~DE SECRET CHEMICAL~ME ~~~ ~Y~ ~ NO 200 207 COM~N ~ME EHS* D Y~ ~ No 208 lbs:.::" '" . :.. ~. ~.': ....:.':?.. :.... '.:' :~?;:;.;;;~?~ FIRE CODE H~RD C~SSES (~mplete if r~u~t~ by I~1 fire ~ie~ 210 ~PE ~ p PURE D m MI~URE ~ w WASTE 211 ~DIOACTIVE ~ Y~ ~ No 212 CURIES 213 PHYSICAL STATE ~ s SOLID ~1 LIQUID ~ g ~S 214 ~RGEST CONTAINER ~ 215 FED H~RD ~TE~RIES ~ I FIRE ~ 2 R~CT~E D 3 PRESSURE REL~SE ~ 4 ACUTE H~LTH ~ 5 CHRONIC H~L~ (~ all that apply) 216 ~NUAL WASTE 217 ~IMUM ~ 218 ~ AVENGE 219 STATE WASTE CODE 220 AMOU~ ~ DAILY A~U~ DAILY ~U~ UNITS* ~ ga ~L ~ d CU ~ ~ lb LBS ~ tn TONS ~1 DAYS ON SITE 222 · If EHS. am~nt must be in lbs. STOOGE CO~AINER D a ABOVEGROUND TANK ~ e P~STI~NONMETALLIC DRUM D i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR (Check all ~at apply) 223 ~ b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~STIC BO~LE D r OTHER ~ c T~K INSIDE BUILDING ~ g ~RBOY ~ k BOX ~ o TOTE BIN ~d STEEL DRUM D h SILO ~1 CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a ~BIENT D aa ABOVEAMBIE~ ~ ba BELOWAMBIE~ 224 STOOGE TEMPE~TURE ~ a AMBIE~ ~ aa ABOVEAMBIE~ Dba BELOW AMBIE~ ~ c CRYOGENIC 225 '=~.:S ~ · :.: .' '.:'~ '~: .'.L::;,;,~;? ~,?~,:~ :.~,~ ,~. : ~{,; ;7~:: ~:~,~ ~; ~'~: F~ ;' ~'[~';~'~ ':. :~,/7' ~' ' ,'::. ' :-": :: L~ .'::'::~ ~ ~:'~;~ ' > I 226 227 ~ Y~ ~ No 228 229  230 231 ~ Y~ D No 232 233 234 235 ~ Y~ ~ No 236 237  238 239 ~ Y~ ~ No 240 241 242 243 ~ Y~ ~ No 2~ 245 ,'~ ,:~: ~:, · :: · : ~,:~:~, , ::.',.',<;,,~.,¢.~;~'~:[j;-;; ::'<?:': , :,,,~:': ::; ,..: ,' :~".. c~.::, ~>~ ~: · ~?~ :'., ;~: ,',,,,:,, ;>;:. ~:~,: +::::::~./-'; ~ v.. : ,,. ~.~: : ,,. ~ ' ~;: , , .;~, -' - ~:'...~ - . PRINT ~ME & TITLE OF AUTHORIZED ~MPA~ REPRESE~ATIVE SIGNATURE DATE 246 DES FORM 2731 (7/98) P:\OES2731 .TV4.wpd CITY OF BAKERS LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one form per matedal per building or area) [] ADD [] DELETE [] REVISE 200 Page __ of __ :" .... :, . ~. ~ :-..! · d' '~',' '.~'~: .:~:i!'::~::i~i?~i ~?': ~F:-~'~."~ :~?i~i~,i,TM ,:" ~ .;L :.:~ F~i~ i~:,' ..i~?:,i ~::,.' : ~.~.~ · ~ · , ~ -. SUSINESS ~ME (Same as FACILI~ ~ME ~ D~ - D~ng Busin~ ~) 3 201 CHEMICAL LOCATION ~ Y~ ~ No 202 FAClLI~ ID ~I ~ ~ ~] ~ ~ I ~P ~ (o~t~naO 203 GRID g (o~t~naO 2~ 205 T~DE SECRET ~ Y~ D No 2~ CHEMICAL NAME ~~ ~~ ~ ~Ul~ If Subj~ to EPC~, refer ,o iinstm~ions 207 ~M~N ~ME EHS* D Y~ ~s ~ 2~ ~.~ E~S ~s~~' a, a~.~ be~~ ~i'~i~:~:. '~.' "~"~ :~'~'..:": '- · · :. '.' ". ~'~' ~:~'..~:.:'-:l FIRE CODE H~RD ~SSES (~mplete if r~u~t~ by I~1 fire ~ieO 210 ~PE ~ p PURE ~ m M~URE ~ w WASTE 211 ~DIOACTIVE ~ Y~ ~ No 212 CURIES 213 PHYSI~L STATE ~ s SOLID ~1 LIQUID ~ g ~S 214 ~RGEST ~AINER ~ 215 FED H~RD CATEGORIES (~ all that apply) 1 FIRE ~ 2 R~CTIVE ~ 3 PRESSURE REL~SE ~ 4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216 A~UNT DAILY AMOUNT ~ DAILY A~UNT UNITS* ~ ga ~L D ~ cu ~ D lb LBS D ~ TONS 221 DAYS ON SITE · If EHS, am~nt must be in lbs. STOOGE ~AINER ~ a ABOVEGROUND TANK ~ e P~STICINONM~ALLIC DRUM ~ i FIBER DRUM ~ m G~SS ~LE ~ q ~IL CAR (Check all ~at apply) D b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~STIC BO~LE ~ r OTHER ~ c TANK INSIDE BUILDING ~ g ~RSOY ~ k BOX ~ o TOTE BIN ~ d STEEL ORUM ~ h SILO D I CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a AMBIE~ D aa ABOVEAMBIE~ Dba BELOW AMBIENT ~4 STOOGE TEMPE~TURE ~ a AMBIE~ ~ aa ABOVE AMBIE~ ~ ba BELOWAMBIE~ ~ c CRYOGENIC ' ~' .... ~ '.~ .-~ .', ..~-~? ?~.~. ~.. · ~..,.~..-. ~,....~ ...~.~ ~.~H~RDOUS COMPONENT~..~...~:~.~ ~: ~..~.. ¥. ...... :.~:.~. 1 226 227 ~ Y~ D No 228  230 231 ~ Y~ ~ No 232 ~3 234 235 ~ Y~ ~ No 236 ~7  238 239 ~ Y~ ~ No 240 241 242 243 ~ Y~ D No 2~ 245 .. PRINT ~ME & TITLE OF AUTHORIZED ~MPANY REPRESENTATIVE SIGNATURE DATE 2~ OES FORM 2731 (7/98) P:\OES2731 .TV4.wl~d CITY OF BAKERS LD OFFICE OF ENVIRONMENTAL SERVICES 1715 Chester Ave., CA 93301 (805) 326-3979 HAZARDOUS MATERIALS INVENTORY Chemical Description Form (one fon'n per material per building or area) I'-1 ADD [] DELETE [] REVISE 200 Page __ of __ BUSINESS NAME (Same as FACILITY NAME or DBA - Doing Business As) 3 CONFIDENTIAL(EPC~) ~ Y~ ~ No 202 205 T~DE SECRET ~ Y~ ~ No 2~ CHEMICAL NAME ~ ~ ~ "Subj~ to EPC~. re,. ,o ,instm~ion. 207 COM~N ~ME EHS' ~ Y~ ~ No 208 FIRE CODE H~RD C~SSES (C~plete if r~u~t~ by I~1 fire ~i~ 210 ~PE ~p PURE ~ m MI~URE ~ w WASTE 211 ~DIOACTIVE ~Y~ ~No 212 J CURIES 213 PHYSICAL STATE D s SOLID ~1 LIQUID ~ g ~S 214 ~RGEST ~AINER ~ 215 FED H~RD CATE~RIES ~I FIRE ~ 2 R~CT~E D 3 PRESSURE REL~SE ~ 4 ACUTE H~LTH ~ 5 CHRONIC H~LTH 216 (Ch~ all that apply) ANNUAL WASTE 217 ~IMUM 218 AVENGE ~ 219 STATE WASTE CODE 220 A~UNT DAILY A~U~ ~ DAILY ~UNT UNITS* ~ ga ~L ~ d CU ~ D lb LBS ~ tn TONS ~1 DAYS ON SITE 222 * If EHS, amount must be in lbs. STOOGE CONTAINER (Check a//~at app/y) ~a ABOVEGROUND TANK ~ e P~STI~NONMETALLIC DRUM D i FIBER DRUM ~ m G~SS BO~LE ~ q ~IL CAR ~3 ~ b UNDERGROUND TANK ~ f ~N ~ j BAG ~ n P~STIC BO~LE ~ r OTHER ~ c TANK INSIDE BUILDING D g C~BOY ~ k BOX ~ o TOTE BIN ~ d STEEL DRUM ~ h SILO ~ I CYLINDER ~ p TANK WAGON STOOGE PRESSURE ~ a ~BIE~ ~ aa ABOVEAMBIE~ ~ ba BELOW AMBIENT ~4 STOOGE TEMPE~TURE ~ a AMBIE~ D aa ABOVE AMBIE~ ~ ba BELOW AMBIE~ D c CRYOGENIC 225 226 227 ~ Y~ ~ No 228 229 230 231 ~ Yes ~ No 232 233 234 235 ~ Y~ ~ No 236 237 238 239 ~ Y~ ~ No 240 241 242 243 ~ Y~ ~ NO 2~ 245 PRINT ~ME & TITLE OF AUTHORIZED COMPANY REPRESE~ATIVE SIG~TURE DATE 246 OES FORM 2731 (7/98) P:\OES2731 .TV4.wpd