HomeMy WebLinkAboutBUSINESS PLAN 2/20/1996 Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This permit is issued for the following:
~,~'~'?i' ,/, ,~:!~:'~:'"~'*::'~.:~i , ~!i!iiii~. iiii[ii'~i iii:~'-::::i?~i~iliU~e[ground Storage of Hazardous Materials
Waste
LOCATION 5551 ALDRIN
~ ':.. '~ ~ ~,.~' "m~ '~",';:, . ~ · ~ ~:'i~'~%= ~[" :i~. · ....~
."~.. "':~ ~:..{ '.,I ~.,~[~:~:...=l~.
'~,~""-::~'~.~ '~t~ " '?'"~:k":'~,,~,. z7 ./"..'"~:'f
~, _':~ N,~:~,, !.., ..',. F~' ~:/ ~ ".."~
· '~ .._. ~ -~' ~ . ,1~...., ~,~l ~ ~', '= '~ 1~,
~. """T::::~F ::$~ .~ili: ~'?.:~,4~:~"'~"C~"1":' ~[:~=-~=~':~ ~ '~ ~ 'i~¢~i~': ~F]' I ' ~i~'
B~ersfield Fke D~ment Approv~ by: ~ '
O~CE OFE~O~AL S~ ~CES ~ph Hu~~
1715 Chewer Ave., 3rd Floor Office of ~en~l S~ie~
B~e~el~ CA 93301
Voice (805)
F~ (80S)~2~STb Expiration~t~: dUn~ ~O~ ~OOO
)1/04/96 BAKER HUGHES INTEQ' 215-000-000106 . . P,~.
Overall Site with 1 Fac. Unit
General Information By
Location: 5551 ALDRIN CT Map:123 Haz:4 Type: 3
] City : BAKERSFIELD Grid: 15D F/U: 1 AOV: 0.0
Contact Name Title Contact Name Title
CHARLES LAY~NCE COMPLE~IONS SPECIALSIST DAVE GUERRERO ACCOUNT R~P.
Business Phone': (805) 834-2844x Business Phone: (805) 834 ~654 x
24-Hour Phone : ( ) - x 24-Hour Phone : ( .) - x
Pager Phone : (805) 334 ~066 x ' Pager Phone : ( ) - x
Administrative Data
Mail Addrs: 5551 ALDRIN CT D&B Number:
City: BAKERSFIELD State: CA Zip: 93313-
Comm Code: 215-013 BAKERSFIELD STATION 13 SIC Code:
Owner: BAKERS HUGHES INTEQ Phone: (805) 834-9654
Address: 5551 ALDRIN CT State: CA
City: BAKERSFIELD Zip: 93313-
F Summary
UY~e or p~t~ r~me) ' --
reviewed the a?~ached hszardous materials manage-
for~~~ ~r~ that it slong with
ment
plan
any corre~ons can~i~ute a complete ~d ~ man-
agement plan ~or my facility.
01/04/96 ~ BAKER HUGHES INTEQ 215-000-000106 Page 4
00 - Overall Site
<D> Notif./Evacuation/Medical
<1> Agency Notification
CALL 911
FIRE DEPARTMENT; HALL AMBULANCE SERVICE
<2> Employee Notif./Evacuation
E?'!PLOYEES TO BE NOTIFIES OF EMERGENCY SITUATION VIA P,A, SYSTEM TO MEET
OUTSIDE IN FRONT OF BUILDING, ACROSS THE STREET,
<3> Public Notif./Evacuation
<4> Emergency Medical Plan
DIAL 911
01/04/96 BAKER HUGHES INTEQ 215-000-000106 Page '5
00 - Overall Site
<E> Mitigation/Prevent/Abatemt
<1> Release Prevention
ACETYLENE AND OXYGEN BOTTLES STORED I~7ITH CAPS SCREWED ON.
<2> Release Containment
REDUCE VAPORS I,TITH FOG OR FINE ~.{IST, RE!~OVE ALL IGNITION IF WITHOUT RISK,
SHUT OFF LEAK IF ~TIT!{OUT RISK, VENTILATE AREA OF LEAK OR !~OVE LEAKING
CONTAINER TO I,~LL VENTILATED AREA,
<3> Clean Up
PREVENT I,~STE FROM CONTamINATING SURROUNDING ENVIRONMENT, DISCARD RESIDUE
IN AN ENVIRON!~_~NTALLY ACCEPTABLE ~NNER, IN FULL COMPLIANCE WITH FEDERAL,
STATE AND LOCAL REGL~ATIONS?
<4> Other Resource Activation
01/04/96 BAKER HUGHES INTEQ 215-000-000106 "~ Page 6
00 - Overall Site
<F> Site Emergency Factors
<1> Special Hazards
<2> Utility Shut-Offs '
A) GAS - FRONT EAST CORNER OF BUILDING INSIDE OF FRONT WALL,
B) ELECTRICAL - BUILDING "A" NORTHEAST~CORNER OF SHOP,
C) WATER - FRONT YARD,
D) SPECIAL - LPG TAN!t, SOUTHI~ST CORNER OF YARD. SHUT-OFF ON TANK
E) LOCK BOX- NO
<3> Fire Protec./Avail. Water.
PRIVATE FIRE PROTECTION - ~.{ANY FIRE ESTINGUISHERS LOCATED THROUGHOUT
BUILDING "A" "B" & "~C"
NEAREST FIRE HYDRANT - F~ONTOF.5%F!LD!I~
<4> Building Occupancy Level
01/04/96 BAKER HUGHES INTEQ 215-000-000106 ~ Page 7
00 - Overall Site
<G> Training
<1> Employee Training
HOW MANY EMPLOYEES AT THIS FACILITY???????????i~HAVE5 ~STDYEES ~ 3
T~ORARY.~.~LO~EES AT ~{IS FACILITY.
DO YOU HAVE MSDS SHEETS ON FILE???????????
t~Si~HAVE~TERIALS~ETYDATASHEETSON FILE.
BRIEF SUMMARY OF TRAINING PROGRAM:
VAP~OUS SAFETY PROGRA~ C~NCEP~NIi~ FIRE, HAZAPJ)OUSCHt~CAk$, ~ FIRST AID, ASWELLAS
PUBLISt~D!~IflI~Y SAFE%YMEETE{GSH~_D1ST~DAY OFEACHMONTH.
<2> Page 2
<3> Held for Future Use
<4> Held for Future Use
~ ~ ~ ~ ' A B.,aker Hughes company
~iSand Control
555? ALDRIN COURT
BAKERSFIELD. CALIFORNIA 933~3
iV-
MATERIAL SAFETY DATA SHEETS
TABLE OF CONTENTS
t. ALUMINIUM STEARATE 37. SUPER GEL
2. AQUAPAC LV. 38. PYRO TROL
3. AQUAPAC R. 39. KEM SEAL
4. STARCH - BIO LOSE 40. HP 007
5. SACK FISHING TOOL 41. POLY DR_ILL
6. CAUSTIC SODA 42. DFE 518L
7. COTTON SEED HULL 43. ACETYLENE
8. CF DESCO 44. AQUA ~4MONIA
9. DRILL THIN ·' 45. AW HYD. OIL
10. HEC 10 46. BAKER BOND
11. DEFOA/~ER LD-8 47. BAKER LOW FINE
12. LIGNITE - LIGCO 48. DIATOMECEOUS EARTH
13. MAGMA FIBER 49. DRY MOLY
14. MIL MICA 50. INFLO 40
15. BARITE 51. MAGNESIUM OXIDE
16. CEDAR FIBER 52. NTA
17. MIL FREE 53. OXYGEN
18. LIME 54. PROPANE
19. MIL PAC LV & REG. 55. SAFTY KLEEN 105
20. NUT PLUG 56. SODIUMPERBORATE MONOHYDRATE
21. MIL SEAL 57. TEQ MIX
22. MIL TEMP. 58. XANVIS
23. MUD DETERGENT 59. A-100~INORGANIC CORROSION·INHIBITOR
24. BENTONITE - MIL GEL NT · 60. A-101 HIGH TEMP. INTENSIFIER
25. BENTONITE - MIL GEL REG. 61. A-114 NONIONIC NON-EMULSIFIER
26. DEFOA~R 62. A-120 SEQUESTERING· AGENT
27. XCD POLYOMER 63. A-170 HYDROCHLORIC ACID,
28. NEW DRILL L 64. B-610 AMMONIUM CHLORIDE
29. NEW THIN 65. S-40 PREHYDRATING FLUID FOR HEC
30. NEW TROL 66. S290·MUTUAL SOLVENT
31. DRILLING PAPER 67.. B-643 BIOCIDE
32. POTASH 68. W-300 BAKER CLEAN GEL I & II
33. SAPP 69. W-322 HIGH TEMP. BREAKER
34. SAWDUST 70. W-324 SPECIAL BREAKER
35. SODA ASH 71. W-321 MEDIUM TEMP. BREAKER
36. BICARB OF SODA 72. W-350 HIGH TEMP. GEL STABILIZER
., BAKER, iJ:IELD CITY FIRE DEPi RTMENT
~ HAZARDOUS MATERIALS INVEIq'I'ORY
Page ,__of_.~
8usinessName l~/~'/'/~., /7/'~?~-":T /~-~Address ~/ ~/~/~ ~7 ~/~~ CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New Addition [ ] Revision [ ] ~letion [ ] Check NON ~DE SECR~ ~ ~DE SECR~
2) Common N~e: ~ ~ 3) ~T ~ (opUon~)
Chemi~ N~e: ~ [ ~
~Z~ AHM [ ] CAS
4) PHYSICAL & H~L~ .2 :AL H~L~
H~RD CA~GORIES ' Fire' [. ]' R'e&cdve [ ] ~n Rele~e of Pressure [ Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic)
5) WASTE C~SSIFICA~ON ~ / (3-digit ~ 8022) USE CODE //
6) PHYSICAL STA~ Solid [ ] Liquid ~ G~ [ ] Pure [ ] Mi~ure ~ W~te [ ] R~ioa~e [
7) AMOUNT AND ~ME AT FACILI~ }F M~SURE 8) STOOGE CODES
M~imum Omly Amount: ~ ~ ~3 [ ] ~) Cont~ner: .
Average O~ly Amount: ~ [ ] b) Pressure: /
Annu~ Amount: /~ ¢ c) Tem~r~ure:
L~gest Size'Container:
¢OaysOn Site 3~ Circle~ich Months: J, F, M, A, M. J, J, A, S, O. N. D
9) MITRE: Ust COMPONENT CAS ¢ % ~ AHM
the three most h~ardous t) C ~2~' ~
chemic~ components or
1 O) Location ~ ~~ ~ ~
/ CHEMICAL DESCRI~ION
V.
1) INVENTORY STA~S: New ~ Addition [ ] Revision [ ] Deletion[ ] Check ~chemi~ is a NON ~DE SECR~ ~ ~DE SECR~
C~.m~c~ N.m~: ~ L ~ ~ ,,~, ~ ~ ~~ A,M [ ] CAS
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RO CATEGORIES Fire [ ~ Reactive [ ] Sudden Rele~e of Pressure [ ~ Immedi~e He~th (Acute) ~ ~layed He~h (Chron,)
5) WASTE C~SSIFICATION ~ / (3-digit code ~om DHS Form ~022) USE CODE
6) PHYSICAL STA~ Solid~ Liquid [ ] G~ [ ] Pure ~ Mi~ure [ ] W~te [ ] Radioamive
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
U~imum Omly Amount: ~60o lbs ~ g~ [ ] fi3 [ ] a) Com~ner:
Average Daily Amount: /~ curies [ ] b) Pressure: /
Annu~ Amount: ~ c) Temper~ure:
~gest Size Container:
·
~ Days On Site ~ Circle ~ich Months: J.F.M.A.M.J.J.A.S. '~ N. D
9) MITRE: Ust COMPONENT CAS ·
'the three most h~dous 1) ~/~/~ ~ ~ ~~ [ ]
chemi~ com~,nen~ or
~y AHM com~nen~ '~ ~ ~/~ ~
[
ce~'~ under pen~ of law. ~at I have pe~onaily examin~ ~d am f~il(~ wi~ ~e infomadon submi¢~ on ~is ~d ~1 a~ch~ document. J beJJeve
PRINT Name& Title of Au~orized Company ~epresenm~ve '
BAKERq, IELD CITY FIRE DEP i ITMENT
H DOUS MATERIALS INVEI I'ORY PageZ_ of 22~
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check ~ chemi~ is a NON ~DE SECR~ [~ ~DE SECR~
[
2) CommonN~e: ~ ~ ~ ~4~ Z ~ ~L-,Zo~/ ~~ 3) ~Tm (option~)
Chemic~N~e: ~M~ ~ ~ AHM[ ] CAS~
4) PHYSICAL & H~L~ ~.:7' PHYSICAL H~L~
H~RD CA~GORIES -' Fire' '[ .]~ R6~ctive [ .~ Sudden Relate of Pressure [ ] Immedi~e He~h (Ac~e) ~] ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~ ~/ (3-digit code from DHS Fo~ 8022) USE CODE / ~
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~Ne
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~Iy Amount: 2~000 t~ ~ g~ [ ] ~3 [ ] a) Cont~ner: .
Average Daily Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: ~ ~ c) Tem~r~ure:
L~gest Size'Container: ~ 0
~ Days On Site __~ Circle ~ich Months: ~J, F. M, A. M. J, J. A, S. O. N. D
9) MITRE: Ust ~ COMPONENT % ~ AHM
,he three most h~ardous 1) ~O Ly ~'o~' ~ ~C~ ~-Os~
chemic~ componen~ or
any AHM com~nents 2) [ ]
3) [
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New { Addition [ ] Revision [ ] Deletion [ ] Check ff chemi~ is a NON ~OE SECR~ ~DE SECR~ ["
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ] Reactive [ J Sudden Relate of Pressure [ ] Immedi~e He~th (Ac~e)
5) WASTE C~SSIFICA~ON ~ ~ / (3-digit code from OHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ Minute [ ] W~te [ ] RadioaOive [
7) AMOUNT ANO TIME AT FACIU~--~ UNITS OF M~SURE 8) STOOGE CODES
M~,mum Daily Amount: /~OOO Ihs ~ g~ [ ] ~3 [ ] a) Cont~oe,:
/
Average O~ly Amount: ~O cudes[ ] b) Pressure:
x Annu~ Amount: / ~ ~ o O c) Temper~ure:
~gest Size Container:
· Days On Site ~ Circle ~ich Months: All Ye~. J. F. M. A. M. J. J. A. S. ~'[ N. D
9) MITRE: Ust COMPONENT CAS · % ~ ~M
the three most h~dous
1)
/
chemi~ com~nen~ or
~y AHM com~nents '2) [ ]
3)
su~mi~ info.aEon is ~e, accurate, and complete.
PRINT Name & T~le of Au~orized Company ~epresenta~'ve Signa~re ~ Da~
; BAKER, IELD CITY FIRE DEP i :ITIVIENT
HAZ I DOUS MATERIALS INVEI rORY
Pag e._=.of._=_
BusinessName_~'P/g/~l;g~_2 __~__~__]1¢"-~ / /UT~7¢ Address ~/ ~L ~ / ~ ~ ~ ~~ e~ ~ ~ ~ ~ /~
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New~ Addition [ ] Revision [ ] ~letion [ ] Check ff chemi~ is a NON ~DE SECR~ ~ ~E SECR~ [ ]
2) Common N~e: ~ ~ ~ ~/ O ~ 3) ~T · (option~)
4) PHYSICAL & H~LTH .,,.~., PHYSICAL H~L~
H~RD CA~GORIES .'Fire' ~ ]{ Re'active { ] Sudden Rele~e of Pressure [ ] tmmedi~e He~h (Ac~e) ~ ~layed He~h (Chronic) [
5) WASTE C~SSIFICA~ON ~2 / . (3-digit code ~om DHS Fo~ 8022) USE CODE / /
6) PHYSICAL STA~ Solid ~l Uquid [ ] G~ [ ] Pure ~ Minute [ ] W~te [ ] R~ioa~e [
7) AMOUNT AND ~ME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~ly Amount: /~ [~ ~ g~ [ ] fi3 [ ] A) Cont~ner: .
Average D~ly Amount: /~ O curies [ ] b) Pressure: /
Annu~ Amount: / ~e c) Tem~r~ure:
L~gest Size Container:
~OaysOnSi[e ~ Circ/e~ich Momhs: ~, F, M, A, M, J, J, A, S, O,
9) MITRE: Ust COMPONENT CAS ¢ % ~ AHM
the three mosth~ardous 1) ~ ~ ~C/ g ~ ¢~ g ¢33/ --~O-
chemic~ componen~ or
any AHM com~nents 2) [
3) [ ]
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New~ Addition [ ] Revision { ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~ ~ ~DE SECR~ [-']
2) Common N~e: ~ ~/( ~/~ ' ~ ~O ¢ ~ 3) ~T ¢ (option~)
Chemic~ Name: ~Z-~ ~/~ ~/0 ~ AHM [ I CAS ·
4) PHYSICAL & H~LTH PHYSICAL H~L~
H~RD CATEGORIES Fire [ ] Reactive { I Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.)
5) WASTE C~SSIFtCATION ~ / (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid ~] Liquid [ ] O~ [ ] Pure [ ] Minute ~ W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
U~,mumOailyAmount: 2 ~0 lbs ~ g~ [ ] fi3 [ ] a) Contaner:
Average Daily Amount: / ~ /~ cudes [ ] b) Pressure:
Annu~ Amount: ~ ~ ~ c) Temper~ure:
~gest Size Container:
· Days On Site ~ ~ ~ Circle~ich Months: ~ J. F, M, A. M, J, J, A. S,.'O~ N, D
9) MITRE: Ust COMPONEN~ CAS · %
chemi~ 6om~nen~ or
.~o) ~o~o. ~ ~~ j~
submiO~ info~a~on is ~e. accurate. ~d complete. ,
PRINT Name & '¢itle of A~orized Compeny Represenm~ve Signa~re / Da~
BAKERSa[IELD CITY FIRE DEPt :ITIVlENT
H DOUS MATERIALS INVEN'FORY Page_, of_ _:
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New~('~ Addition [ ] ] Deletion [ 1 Check if ch, NON TRADE SECRET [~j TRADE
SECRET
[
2) CommonNarne: ~,~ CC / ~,n,~ 7'A' 4Z.~O -~o ,..~ 3) DOT # (optionaJ)
4) PHYSICAL & HEALTH ,2' PHYSICAL HEALTH
HAZARD CATEGORIES ' Fire' { .]: Rea~:tive [ ~ Immediate HeaJth (Acute) ~ D~layed Health (Chronic) [
5) WASTE CLASStFtCATION "~ 2./ (3-digit code from OHS Form 8,02 USE CODE
6) PHYSICAL STATE Solid ~. Uquid [ I Gas { ] Pure [~3'" Mixture [ ] Waste [ ] RadioactNe [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF 8) STORAGE CODES
Maximum Da~ly Amount: ~'~ 0 0 lbs [~ gal [ [ ] a) Container: ./ ~-
Average Daily Amount: ~1 curies [ b) Pressure:
AnnueJ Amount: ~ O o~ c) Tempere/ure:
largest Size Container:
# Days On Site ,~ 6~" Circle Which Months: J, F. M. A, M, J, J, A. S, O, N, 0
9) MIXTURE: Ust COMPONENT CAS # o~ WT AHM
chemical components or
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New M Addition [ ] Revision [ ] Deletion[ ] Check ifchemicaJ is a NON TRADE SECRET [,/~ TRADE SECRET
2) Common Name: ~" ~'~" (." "~ 3) DOT # (optional)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ) Reactive I ] Sudden Retease of Pressure [ ] Immediate Health (Acute) [/~1 D~layed Health (Chronic) [
5) WASTE CLASSIFICATION ,.~ ~ / .(3-dig~t code from DHS Form 6022) USE COOE //
6) PHYSICAL STATE Solid [~ Liquid [ I G~s [ ] Pure/J~ Mixture [ ] Waste [ 1 Radioactive [ ]
7) AMOUNT AND TIME AT FAClUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: g~ 6~0 lbs ~ gaJ [ ] fi3 J ] a) Container: // Z.
Average Daily Amount: _.,~,~'~ed cudes [ ] b) Pressure:
Annual Amount: ,/~:;~ ~O, c) Temperature:
Largest Size Container: .___.~O
# Days On Site ~'~,,~'~' Circle VVhich Months: All Year, J. F. M. A. M, J. J, A. S. (3'; N. D
9) MIXTURE: List COMPONENT CAS # % v~r AHM
chemical components or
any AHM components '2) 1 ]
3) [ ]
~ef~ty under penaJq; of/aw, that/have personaiiy exam/ned and am ,amiiia]' with the infomadon ,ub~J~ecl on this and ail affac,hed documents.,belJeve thu
PRINT Name &f Title of Authorized Company RepresentatNe Signature .( Date
BAKER: ii IELD CITY FIRE DEPi iJFITMENT
H DOUS MATERIALS INVEI TI'ORY
Page.
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check ~ chemJ~ is a NON ~DE SECR~
2) Common N~e: ~~~ ~ ~ 3) ~T · (option~)
4) PHYSICAL & H~L~ ..:? PHYSICAL H~L~
H~RD CA.COPIES : Fire' [ .]~ Reactive [ ~ Sudden Relume of Pressure [ ] Immedi~e He~h (Ac~e)
5) WAS~ C~SSIFICA~ON ~/ (3-digit cede from OHS Fo~ 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] O~ [ ] Pure ~ M~ure [ ] W~te [ ] R~Joa~Ne [
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~ly Amount: /¢~ lbs ~ g~ [ ] ~3 [ ] a) Contaner:
Average O~ly Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: c) Tem~r~ure:
~gest Size'Container:
¢ DaysOn Site Z~ Circle~ich Months: ~J, F, M, A, M, J, J. A, S, O, N. D
9) MITRE: Mst COMPONENT CAS ¢ % ~ AHM
the three most h~ardous 1) [ ]
chemic~ components or
any AHM com~nents 2) [ ]
CHEMICAL DESCRI~ION
1) INVENTORYSTA~S: New~ Addition[ ~ Revision[ ] Deletion[ ] Checkffchemi~is a, ~OESECR~ ( i ~ESECR~
2) Common N~e: ~ ~ 3) ~T · (option~)
Chemic~ Name: ~ ~, C ~- ' ~ ~ ~, ~c~ AHM [ ] CAS
4) PHYSICAL & H~L~ H~L~
H~RD CATEGORIES Fire [ ] Reactive[ ] Rele~e of Pressure [ ] Immedime He~h (Ac~e)
5) WASTE C~SSIFICA~ON ~ / .{3-digit code Eom DHS )tm 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure [ ] Mi~ure [~ W~te [ I Radioa~ive
7) AMOUNT AND TIME AT FAClU~ OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: /~ ~ 0 ~ { ] ~3 [ ] a) Cont~ner: /
Average O~ly Amount: ~ ~0 [ ] b) Pressure: /
Annu~ Amount: ~ o o o o c) Temper~ure:
~gest Size Container: ~ ~
· Days On Site ~ Circle ~. F, M. A. M. J. J. A. S.'O~ N. D
9) MITRE: Ust COMPONENT' CAS ~ % ~ ~M
the three most h~dous 1) ~ / ~ ~l 0 ~
chemi~ com~nen~ or
ce~ under pen~ of Jaw, ~at I have pe~onaily examin~ ~d am f~iJi~ wi~ ~e infomadon s~j~ on ~ls ~d ~l a~ch~ document.
submiC~ info~adon is ~e, accumte, ~d cqmplete. , /~- ~
PRINT Name ~tle of A~orized Company Representative Signa~re ( Da~
, BAKER, ii IELD CITY FIRE DEP RTMENT
H DOUS MATERIALS INVEI I'ORY
Page., 'of ~__'
,/ CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New,'1 Addition [ ] Revision [ I Deletion [ ] Check if chemical is a NON TRADE SECRET !~.f TRADE SECRET
2) Common Name: ~--~'~'f~'~/~' ~:/?.-&'~ J-~ 3) DOT#(optionaJ)
4) PHYSICAL & HEALTH ..:. PHYSICAL HEALTH
HAZARD CATEGORIES · Fire' ( .]: Reactive i ] Sudden Release of Pressure [ ] Immediate HeaRh (Acute)
5) WASTE CLASSIFICATION ~ 2..-/ (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid [,~. Liquid [ ] Gas [ ] Pure ~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Oaqy Amount: / 00C;> lbs ~ gal [ ] ft3 [ ] a) Container: / ~
Average Daily Amount: / 0 ~ 0 curies [ ] b) Pressure: /
Annual Amount: / 0 ¢ o c) Temperature: .~7,,/
Largest Size'Container: ~"-~
# Days On Site ~'~,..1'"' Circle Which Months: ~'-Ye~,~J, F, M. A. M, J. J. A, S, O, N. D
9) MIXTURE: List COMPONENT CAS # % VV'T AHM
the three most hazardous 1 ) [ ]
chemical components or
any AHM components 2) [ ]
./ CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New ~' Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET
2) Common Name: ~----/-~'~ ~ .,~ 3) DOT # (opfionat)
ChemicaJName: ~/ ~- /~n~l O~ ~/~'/~/Z.OC /~y~-2~' AHMI ] CAS#
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ) Reactive [ } Sudden Release ot Pressure [ ) Immediate Health (Acute) [j('~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION 5 ~ / (3-digit code from OHS Form 8022) USE CODE ///
6) PHYSICAL STATE Solid ~ Liquid [ ] Gas [ ] Pure [ ] Mixture ~ Waste [ ] Radioactive [ ]
7) AMOUNT AND TiME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Oaily Amount: .,~ ~'"'O {P lbs [~ gal [ ] ft3 [ ] a) Container: /'2-.
Average Daily Amount: .,,~'~4"'D cunes[ ] b) Pressure: /
Annual Amount: ~ ~.. ~ 0 c) Temperature: y
Largest Size Container: ~
# Days On Site ,~ ~.¢" Circle VVhich Months: ~"AIIYe~J, F, M, A. M. J. J, A.
S, .-~:'
N,
D
9) MIXTURE: Ust COMPONENT CAS # % ~ AHM
chemicaJ components or
~e~ under penW~ o~ ~aw, ~at I have pe~onafly exam~n~
sub~i~ info.aNon is ~e, accu~te, ~d complete. /
PRINT Name & ~tle of Au~orized Company Represen~ve Signa~re
BAKER, IELD CITY FIRE DEP i :ITMENT
HAZ II:IDOUS MATERIALS INVER"i'ORY Page~of~:.':?.,
Business Name ~/~/'~2/'~'-~7~ ' W~'} ¢'-£ //1//'~ Address
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New ~(~ Addition [ ] Revision [ ] Deletion [ ]
Check ff chemiceJ is a NON TRADE SECRETt[~' TRADE SECRET
2) Common Name: /~)f'L. / C~ /-'-~, ,"-) 3) DOT # (optionaJ).
ChemicaJName: ~ / ,k"7'f~¢ /'~ AHM [ I CAS#
4) PHYSICAL & HEALTH . ...~. PHYSICAL HEAL'IH
HAZARD CATEGORIES Fire [. ] Reactive [ ] Sudden Release of Pressure [ ] Immediate HeaJth (Acute) [/~] Delayed Health (Chronic)
5) WASTE CLASSIFICATION ~'- ~'"/. (3-digit code from DHS Form 8022) USE CODE
PHYSICAL STATE Solid /~ Liquid [ } Gas [ ]' Pure ~' Mixture [ } Weste [ ] Radioactive
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: /2.~;00 lbs ,Df] gaJ [ ] ft3 [ ] a) Container:
Average Daily Amount: ~¢ 2-o curies [ ] b) Pressure:
AnnuaJ Amount: .~'~ ~, o ~ c) Temper~ure: ,
L~rgest Size'Container:
# Days On Site ,~'~,r" Circle Which Months: All Yea~. J. F. M. A. M. J. J. A. S. O. N. D
9) MIXTURE: Ust /~ _ __ COMPONENT CAS# %WT AHM
chemical components or
any AHM components 2) ~__//¢'~lJ'~'-~//~/''~'t""' ~..~ ~.,C-~'~ ///'~i'Z,O~'../ ~ J
3) [ ]
./ CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New ~*] Addition [ ] Revision [ ] Deletion [ ] Check h' chemical is a NON TRADE SECRET M TRADE SECRET ['* ]
2) Common N~"ne: //~ ~--C~ / O 3) OOT# (optional)
Chemical Name: ~ ~)/'7-~ A~/~ ~'~'~) ~'~ C-~*~-~/'w' z'~'~ '"t'c'~ AHM[ ] CAS#
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] immediate Health (Acute)
5) WASTE CLASSIFICATION '~'~/ .(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid
7) AMOUNTMA~iDm~ImM ED~i:y FAABC~/~ ./~-- ~ jbUsN~T~ Og~ iSSU~R3E[ ] 8) STORAGE CODEScl.) Container:
Average Daily Amo¢~t: / cunes[ ] b) Pressure:
Annual Amount: J / c) Temperature:
L~gest Size Contai~e~: ___
#,Days On Site \___ / Circle Which Months: AI1Ye~r. J. F. M. A. M. J. J. A. S..O'. N. D
9) MIXTURE: List ~'~ COMPONENT CAS # % WT AHM
chemi~ com~nen~ or
~y AHM com~nen~ '2)
3) [ ]
cerdly under penalty of law, that I have personally examined and am familiar wifll the infomafion sub~'Jl, tted on this and all attached documents. I believe
RINT Name & Title of Authorized Company Ropresentat~'ve Signatore ~ Dat~
BAKER, i IELD CITY FIRE DEPi TMENT
HAz. DOUS MATERIALS INVENTORY Page of: :.'.
CHEMICAL DESCRIPTION
1 ) INVENTORY STATUS: New~.~' Addition [ ] Revision [ ] Deletion [ ] is a NON TRADE SECRET [.,~ TRADE SECRET
[
2) Common Name: ,~J-} ~ 3) DOT # (optional)
4) PHYSICAL & HEALTH .,.,-' HEALTH
HAZARD CATEGORIES .' Fire' '[, ] Re,~ctive [ Sudden Release of Pre., [ ] Immediate Health (Acute) 0(~ Delayed Hea~th (Chronic)
5) WASTE CLASSIFICATION ~/. (3-digit DHS Form USE CODE
6) PHYSICAL STATE Solid [ ] Liquid/~ Gas [ Pure [ ] Mixturex Waste [ ] R~dioective [
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: //2-,'O [] gaJ [~ ft3 [] a) Container:
Average Daily Amount: //~. curies [ ] b) Pressure:
Annual Amount: //Z.~ c) Temperature:
Lazges[ Size'Container:
# Days On Site Circle onths: J, F, M. A, M. J. J, A, S, O. N. D
9) MIXTURE: Ust ,...../ COMPONENT CAS # % WT AHM
chemical components or
any AHM components 2) [ ]
3) [ ]
~ CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New J~ Addition [ ] Revision [ ] Deletion [ ] Check ~f chemica~ is a NON TRADE SECRET
2) Common Name: '~"'~/~ ~ ~'"'~. 3) DOT # (optional)
Chemical Name: Z ..~ -- g:) AHM [ ] CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ J Sudden Release of Pressure { ] Immediate HeaJth (Acute) [/~ Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION ~ ~ / .(3-digit code from DHS Form 8022) USE CODE / /
6) PHYSICAL STATE Solid [ ) Liquid [/~ Gas [ ) Pure [ ] Mixture ~ Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACIUTY ~ O UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: lbs [ ] gal [)~' ft3 [ ] a) Container: / 0
Average Da~ly Amount: ~'<~ o curies [ ] b) Pressure:
Annual Amount: ~. ~:~ ~ c) Temper~ure:
Largest Size Container: ,.~ .
# Days On Site ,~'~,..t"" Circle Which Months: ~ J, F. M. A. M. J, J. A, S..-O; N, D
9) MIXTURE: Ust ~ C2....MPONENT CAS #
AHM
chemical components or
~ny AHM components '2) [ ]
3) [ I
cer~fy: under penalty of/aw, that I have personally exam/ned and am familiar with the inforna~on su~itted on this and all attached docurnen~s.
submitted inforrnat]'on is tTue, accurate, and complete. ,_~//~
PRINT Name & Title of Authorized Company Representative Signature ,./ Date
BAKER, IELD CITY FIRE DEP :ITMENT
H DOUS MATERIALS INVER=rORY
Page?~"o?
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New~ Addition [ ] Revision [ ] ~letion [ ] Check ~ chemi~ is a NON ~DE
SECR~
~DE
SECR~
2) CommonN~e: //~/~ - Z /~ 3) ~T ¢ (optiona)
Chemi~ N~e: ~' ~ ~1 o~ ~~ ~ AHM [ J CAS ~
4) PHYSICAL & H~L~ .,?. PHYSICAL H~L~
H~RD CA~GORIES - Fire' '{ .]' R~active [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acme) ~ ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~/. (3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioamNe J
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~ly Amount: /~O~O lbs ~ g~ [ ] ~3 [ ] a) Contaner:
Average Dmly Amount: ~¢¢ curies [ ] b) Pressure:
Annu~ Amount: ~Oo o ¢ c) Tem~r~ure:
L~gest Size'Container:
¢ Days On Site ,~ ~ Circte~ich Months: ~ J, F, M, A, M, J, J, A, S, O. N. D
9) MITRE: List ~ COMPONENT C&S ¢ % ~ AHM
the three most h~ardous 1 )
chemic~ componen~ or
~¢3 7 []
anyAHMcom~nents 2) ~/ ~ ., ~~~ ~~ /~o -~o-~
3) [
~0) ~o:.~io~ ~~e-~F
CHEMICAL DESCRI~ION
1) INVENIO~Y ST~S: ~ew [~ Addition [ ] Bevision [ ] ~eletion [ ] Check ~ chemic~ i~ a ~O~ ~ S[C~
2) Common N~e: ~ ~ ~ ~/~ 3) ~T ¢ (option~)
Chemic~ Name: ~ ~/~/~ ~~ AHM [ ] CAS~
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ~ Reactive [ ] Sudden Rele~e of Pressure [ ] Immedime He~th (Ac~e) [~ ~layed He~h (Chron,)
5) WASTE C~SSIFICATION ~ ~/ (~digit code from DHS Form 8022) USE CODE //
6) PHYSICAL STATE Solid ~ Liquid [ ] G~ [ ] Pure ~ Mi~ure [ ] W~te [ ] Redioa~ive [
7) AMOUNT AND TIME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Oaily Amount: /~ ~O lbs ~ g~ [ I fl3 [ ] a) Cont~ner: /
Average O~ly Amount: ~ ~ cunes[ ] b) Pressure:
Annual Amount: ~G ~ 8 c) Temper~ure:
~gest Size ContAiner: ~ O
¢ Days On Site ~ ~ Circle ~ich Months: All Ye~. J. F. M. A. M. J. J. A. S..O':' N. D
9) MITRE: Ust COMPONENT CAS · % ~ ~M
the three most h~dous 1) [
chemi~ com~nen~ or
~y AHM com~nents '2)
' ce~'~ under pen~ of law, ~at I have pe~ona/Iy examin~ ~d am f~ili~ wi~ ~e infomadon ~i~ on ~is ~d ~/a~ch~ document. / believe
submi~ info~a~on is ~e, accurate, ~d complete. ,lit ).',~ .
~RINT Name g :fie of A~orized Company Represen~dve Signa~re ~ Oa~
BAKER,IIELD CITY FIRE DEP{ RTMENT
HAZ' RDOUS MATERIALS INVEN-I'ORY Page/,.': of.-' ~,'
CHEMICAL DESCRIFrTION
1) INVENTORY STATUS: New,~"1 Addition[ ] Revision[ I Deletion[ ] Check if chemical is a NON TRADE SECRET ¢ TRADE SECRET [ ]
4) PHYSICAL & HEALTH -.,.';" PHYSICAL HEALTH
HAZARD CATEGORIES :' Fire' '[. ]" Reactive [ i .Sudden Release of Pressure [ [ Immediate Hestth (Acute) ~. Delayed Hea. tth (Chronic) [ ]
5) WASTE CLASSIFICATION ~'-'~""/ (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid [~ Liquid [ ] Gas [ ] Pure ]~ Mixture [ ] Waste [ ] Redioactive [ ]
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~.j--O0 [bs~,~ gaJ [ ] ft3 [ ] a) Container: "
Average Dally Amount: ~..2..,r"o curies [ ] b) Pressure: ,,
Annued Amount: ~ c) Temperature:
Largest Size'Container:
# Days On Site ,.,~" Circle Which Months: All Year. J, F, M, A, M. J, J. A, S, O, N. D
9) MIXTURE: List COMPONENT CAS Cf % WT AHM
the three most he~7.ardous t) ~ ! ~f~',~ /~. 00/ - 2.(~- ~ .~Od [ I
chemical components or
any AHM components 2) ~'¢~ / ,
3) [ 1
CHEMICAL DESCRIPTION
1) INVENTORY STATUS. New [,~' Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ¢~/] TRADE SECRET [' ]
2) Common Name: ~:2~,.~. ! /-~ 3) DOT # (optional)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
[ ] Reactive.[ ] Sudden Release of Pressure [ ] Immediate HeaJth (Acute) DC" Delayed HeaJth (Chronic) [ ]
HAZARD
CATEGORIES
Fire
5) WASTE CLASSIFICATION "~'// .(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ~r' Liquid [ ] Gas [ ] Pure J~ Mixture [ ] Waste [ ] Radioactive ( ]
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
gaJ [ ] ft3 [ ] a) Container: / ~
Maximum
Daily
Amount:
Average Dally Amount: ' ~/7 ~. o~ 0
Annual Amount: ~~::~O ~ c) Temperature:
LaJ'gest Size Container: ' /~::~ ~
# Days On Site ,.,.~C" Circle Which Months: All Yeax. J, F, M. A. M, J, J. A. S, '(D; N, D
9) MIXTURE: List COMPONENT CAS # ~%/_~ AHM
chemical componenL~ or
Cen~/~ undJr penaJ~/ of /aw, that I have personally exarn¢~ned and am ~am/liar with the/ntomadon subm/tted on this and ail attached docurnent~. I believe
PRINT Name/~ Title o! Authorize~ Company Representa~ve Signature / ' Date
BAKER,. iELD CITY FIRE DEPiJ TMENT
HAZIR?IDOUS MATERIALS INVEN 'ORY
Page:U_of :' ·
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check ~ chemi~ is a NON ~DE SECR~ .[~
~DE
SECR~
[
]
Ch~i~ N~: .... A,M [ ] CAS
4) PHYSICAL & H~L~ ....~, PHYSICAL H~L~
H~RD CA~GORIES - Fire (. ] Reactive [ ] Sudden Reie~e of Pressure ( ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic) [ ]
5) WASTE C~SSIFICA~ON ~ / (3-digit code from DHS Fo~ 8022) USE CODE / /
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] Radioa~Ne [ ]
7) AMOUNT AND ~ME AT FACtU~ UNITS OF M~SURE 8) STOOGE CODES
M~,~um ~yAmo.n~: /~ ~ ~] g~ [] ~3 [] ~)Co,~,~:
Average Omty Amount: ~ ~O curies [ ] b) Pressure:
Annu~ Amount: ~O c) Tem~r~ure:
L~gest Size Container:
~ DaysOnSite ~ Circte~ich Months: ~. J, F, M, A. M, J, J, A. S, O, N, D
9) MI~JRE: List COMPONENT CAS · % ~ AHM
~hemic~ compo~ents or
~j aqy AHM com~nents 2) ~ [ ]
,/' CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New [~ Addition [ ] Revision [ ] Oeietion [ ] Check ~ chemi~ is a NON ~DE SECR~
2) Common N~e: ~ / ~ ~ 3) ~T ~ (option~)
4) PHYSICAL & H~L~ PHYSICAL. H~L~
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ } Immedi~e He~h (Ac~e)
5) WAS~ C~SSIFICA~ON ~ ~ / ,(~digit code from DHS Form 8022) USE COOE
6) PHYSICAL STA~ Solid [ ] Liquid ~] G~ [ ] Pure [ ] Minute ~ W~te [ ] Radioa~ive [
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE COOES
U~imum Daily Amount: ~ ~ lbs [ ] g~ ~] fi3 [ ] a) Cont~ner:
Average D~ly Amount: ~// cunes [ ] b) Pressure:
Annu~ Amount: ~ ~ c) Temper~ure:
~gest Size Container:
· D~ys On Site c~&~ Circle ~ich Months: . J, F. M, A. M, J, J. A. S..'~ N. D
9) MITRE: Mst ~ COMPONENT~,[~C ~ ~ ~2 ~cas'~- ~~ , ~M
the three most h~dous 1) ~ ~ ~ ~ ~f~. '
chemi~ com~nen~ or / i
~y AHM com~nenm '2) J
3) [ l
.~0) Lotto, ~~ ~,/~
ce~ under pen~ o~ law, ~at ~ have pemonally examin~ ~d am f~ilmr wi~ ~e/nfoma~on s~'~/on ~is ~d ~1 a~ch~ documenm. I believe
submi~ info.aEon is ~e, accu~te, ~d complete. / . ~
: . . .
RINT Name & Title of Au~onzed Company ~epresenm~'ve ~ s[~na~re ,/
BAKERSFIELD CITY FIRE DEP :ITMENT
HAZ DOUS MATERIALS INVEI FORY Page'.,,'::. of
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New~/Addition [ ] Revision [ ] Deletion ( ] Check if chemical is e NON TRADE SECRET [/~ TRADE SECRET [ ]
2) Common Name: ~- / ~ L~ 3) DOT # (opQon~l)
4) PHYSICAL & HEALTH , ,2,' PHYSICAL HEA~.TH
HAZARD CATEGORIES 'Fire:' [ .]: Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) ( ] '
5) WASTE CLASSIFICATION g2~/ (3-digit code from OHS Form 8022) USE CODE / /
6) PHYSICAL STATE Solid ~ Liquid [ ] Gas [ ] Pure ,~ Mixture [ ] Waste [ ] Radioactive
7) AMOUNT AND TIME AT FACtUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: .~000 lbs ~ gal [] ft3 [] a) Container: /,~
Average Daily Amount: ~ ~ curies [ ] b) Pressure: /
Annual Amount: .,~ __~0 c) Temperature: ¢.~.
Largest Size'Container: ~.~'0
.~----.~
# Days On Site 3~:=,;::~"" Circle Which Months: '~A11~, F, M, A, M, J, J, A, S, O,
N.
D
9) MIXTURE: Ust COMPONENT CAS # % WT AHM
The '.hr~.e most h~ardous ~) ~,g~c; ~.,-~ //y ~..~,~' /Zo ,r- g z.- o /oo [ ]
chemic~ components or
any AHM components 2) [ ]
3) [ ]
CHEMICAL DESCRIPTION
_ 1) INVENTORY STATUS: New'~] Addition [ j Revision [ ] Deletion ( ] Check if chemical is a NON TRADE SECRET [~¢' TRADE SECRET
2) Common Name: ~ / ~/_ /'~/~ (-..~ /-- ~/ ¢- /24:"~' 3) DOT # (optional)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) Ik'1° Delayed HeaJth (Chronic)
5) WASTE CLASSIFICATION ~5-'2,-'/ (3-digit code from DHS Form 8022) USE CODE /,/
6) PHYSICAL STATE Solid .b~ Liquid [ ] Gas [ ] Pure ~ Mixture [ ] Waste [ ] Radioactive
7) AMOUNT AND TIME AT FAGIUTY UNITS OF-MEASURE 8) STORAGE CODES
Maximum Daily Amount: _,~00 0 lbs N gal [ ] f~3 [ ] a) Container: /
Average Daily Amount: ~;)~ o cunes[ ] b) Pressure:
Annual Amount: _~../~ ¢) c) Temperature:
Largest Size Container: --..~"0 . ; . /
# Days On Site ~ ~'5'~' Circle Which Months: ~ J. F. M, A. M. J, J, A, S,.'O; Ni D
9) MIXTURE: Ust COMPONENT CAS # % '¢,q'~ AHM
chemical components or
any AHM c~mponents '2) [ ]
3) [ ]
ce~'/y under penalty of law, that I have personally examined ~nd am familiar with the infomadonl~u~mitted on this ~nd ail alteched document. I believe
submittedinformationistrue, accurate, andcomplete.~,~.,,:y ~ . ~~,~l,'~'~' -'~ ' '"~/~'~'~ / '
PRINT Name & Title of Authorized Company Representative S~gnature / Date
BAKER, iELD CITY FIRE DEPi i ITMENT
H~DC
~US MATERIALS INVEI IY Page._/'/of.~.__~,
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New [~ Addition [ ] Revision [ ] ~letion { ] Check ~ chemi~ is a NON ~DE SECR~ ~OE SECR~ [ ]
2) Common N~e: ~ ~ ~ ~ 3) ~T ~ (option)
4) PHYSICAL & H~L~ ,.~.' PHYSICAL H~L~
H~RD CA~GORIES :' Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e)
5) WASTE C~SSIFICA~ON ~'/ (3-digit code from DHS Fo~ 8022) USE CODE
PHYSICAL STA~ Solid ~ Uquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~e [
6)
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imumDmlyAmount: /~dO I~ ~ g~ [ ] ~3 { ] a) Contmner: ../2
Average Om~ Amount: ~ ~ curies [ ] b) Pressure:
Annual Amount: ~O c) Tem~r~ure:
L~gest Size'Container: ~ ~
~ Days On Site
Circle~ich Months: ~J, F. M, A, M, J. J, A, S, O, N,
9) MITRE: Ust COMPONENT ~ CAS · % ~ AHM
chemic~ components or
any AHM com~nen~ 2) [
3) [ I
CHEMICAL DESCRI~ION
1) iNVENTORY STA~S: New [~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~
Chemic~Name ~ ~ ~o~0 ~/~ ~-~.~~' AHM[ ) CAS~
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Reie~e of Pressure [ ] Immedi~e He~h (Acute) ~ ~layed He~h (Chron,) [
5) WASTE C~SSIFICA~ON ~/ .(3-digit code from DHS Form 8022) USE CODE
G) PHYSICAL STA~ Solid ~ Liquid [ ] g~ [ ] Pure [ ] ~i~ure ~ W~te [ I Radioamive [ ]
7) AMOUNT AND TIME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum OmiyAmounL ~ lbs ~ g~ ti ~3 ti a) Contaner: /~ .
Average O~ly Amount: ~o cuaes [ ] b) Pressure:
Annual Amount: ~ c) Tem~r~ure:
~gest Size Container: ~_ .
~ Days On Site Circle ~ich Months: ~ J. F. M. A. M. J. J. A. S."g~' N. D
9) MITRE: ~st COMPONENT CAS ~ % ~ ~M
the three most h~dous 1) [ J
chemi~ com~nen~ or
~y AHM com~nen~ '2) [ J
3)
ce~ under pen~ of law. ~at I have pe~onaily examJn~ ~d am tmJli~ w~ ~e JnJomadon su~ on ~Js ~d ~J a~ch~ document. I believe
submi~ info~a~on is ~e, accurate, ~d complete.
PRINT Name /Title of Au~orized Company Represen~gve ~ Signa~re .~ Da~
BAKER. iELD CITY FIRE DEPi i ITMENT
H DOUS MATERIALS INVEi TrORY
Page/J~fZ ?-"
Business Name ~/~"~/~.~_-"Z2~ .fl//~?////~? /,,~"/,2-Z~Jd~ Address .-~c-J'-J~/ ,~/__.,/.~/2/~ 0"2'- ~:2,,¢,/~'4-¢/.~,~"¢/,.,0 ~',~,.,,>/...~
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New ~/ Addition [ ] Revision [ ] Deletion { ] Check if chemical is a NON TRADE SECRET ¢(] TRADE SECRET [ ]
2) Common N~me: ~ / ¢ "~.'--23 ') /'~ 3) DOT # (optional)
ChemicaJ Name: ,/~ / /.. ~'~--"'~'1 ~ AHM [ ] CAS #
4) PHYSICAL & HEALTH .>.?' PHYSI£AL HEALTH
HAZARD CATEGORIES Fire' I,]! Re'~,ctiveI ] Sudden Release of Pressure [ ] Immediate Heatth (Acute) ,0~ Delayed Health (Chronic) [
5) WASTE CLASSIFICATION ~ ~'~/ (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid J~ Liquid I ] Gas ! ] Pure [ ] Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~....~0~;) lbs ~ gal [ ] fi3 [ ] a) Container:
Average Daily Amount: ,.5"~-0 curies [ ] b) Pressure:
Annual Amount: ~..,.¢~--0 ~ c) Temperature:
Largest Size'Container: ~ . ¢~
# Days On Site ,~ ~ Circle Which Months: (~.ye.~ J, F, M. A, M, J, J, A, S, O, N, D
9) MIXTURE: Ust COMPONENT CAS # % WT AHM
chemical components or
.3) [ ]
CHEMICAL DESCRIPTION
1) iNVENTORY STATUS: New [/~ Addition I ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [
2) Common Name: -'~ ~' ~._ ~ ~-"7-~--~_~ e",U'T'- ~ -'~ D __ 3) DOT # (optionai)
4) PHYSICAL & HEALTH PH',/SICAL HF_~TH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release ct Pressure [ ] Immediate HeaJth (Acute) ~ Delayed Hea~th (Chronic) [ ]
5) WASTE CLASSIFICATION ..~,~/ (3-digit code from OHS Form 8.022) USE CODE ~/
6) PHYSICAL STATE Solid [ ] Liquid lN~¢' Gas [ ] Pure [ ] Mixture ~' Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILJTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~.~ ~ lbs [ ] gal ,~] ft3 [ ] a) Container:
Average Daily Amount: /,~ ~ cunes [ ] b) Pressure: /
Annual Amount: '~'-_~O c) Temperature:
Largest Size Container:
.5
·
# Days On Site ,-~""' Circle Which Months: J, F. M, A. M, J. J. A. S.''0; N, D
9) MIXTURE: Ust COMPONENT CAS # % WT AHM.
the three most hazardous 1) /4~LC'¢¢/~¢// ~--~'7'~ ~b~yZ/~-~ f/v~/~,f~-~
chemicad components or /
any AHM components '2) [ ]
3) [ ]
/-~er~Jfy under penalty oi law, that I have personally examined and arn tarniliar with the intornatJon ~ubrnitted on this and all attached documents. I believe the
~u,~rnitted information is true, accurate, and complete. ! ~-- /
PRINT Narne/~ Title of Authorized Company Representative ¢ ~ignature~/ Date
BAKERS i IELD CITY FIRE DEP i[:ITMENT
HAZ'II! DOUS MATERIALS INVEN3 'ORY
Page/:':':- of ---
Business Name _ ~,,~/~'-~'l~ ,,~2~,~,,,~/'"~T ~'~Address ~/ /~// ~ ~/~~ ¢~
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check~chemi~ is ~ NON ~DE SECR~ ~ ~DE SECR~ [ ]
2) CommonN~e:_ ~/~/~ ~ ~/~ ~ 3) ~T ¢ (opaon~)
Chemical Name:.__ ¢¢','~,) ~'-'-~¢:)~1.,//7'~- ~Z~ AHM [ ] CAS ~
4) PHYSICAL & H~L~4 ,.~., PHYSICAL H~
H~RD CA~GORIES ' Fire' { }: Reactive { ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~) , ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~Z/ .(3-digit code from DHS Form 8022) USE CODE //
6) PHYSICAL STATE Solid ~ Liquid [ ] Gas [ ] C~O<~L m'*r~,Pure [/~ Mixture [ i Waste [ ] RadioactN'e [ ]
7) AMOUNT AND 'rIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum DaJly Amount: il,FoOD lbs ~] gal [ ] ft3 [ ] a) ContaJner: /~...
Average Dally Amount: ~',.T'~-O curies [ ] b) Pressure: I
Annual Amount: ~:;~¢0 <~0 C~ c) Temperature: ~
Largest Size'Container: ,~ ~ OD
# DaysOnSite ~'~:,.r' Circle Which Months: ( AII~;~,; J, F, M. A, M. J, J, A, S, O, N, O
9) MIXTURE: Ust COMPONENT CAS # % w'r AHM
chemic~ com~nents or
CHEMICAL DESCRI~ION
1) INVENTORY STATUS: New ~ Addition [ ] Revision [ j Deletion [ ] Check ~ chemi~ is a NON ~DE SECRET,,~ ~DE SECR~ [.' ]
2) c~mmcn'N~e:__ /¢~~/ ~ -- ~ / L ~ ~¢~ 3) ~T ¢ (option~)
Chemic~ Name: ~~/' ~ ~'~- ~: AHM[ ] CAS ~
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] immediate Health (Acute) ~/] Delayed Health (Chronic) [ 1
5) WASTE CLASSIFICATION. ~ 4.- / (.3-d,git code from,. DHS Forrn 8022) USE CODE __
6) PHYSICAL STATE Solic J~ Liquid [ ] Gas [ ] Pure [,~ Mixture [ ] Waste [ ] Radioactive
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
M~x,mumOailyAmount: ~/~_~0 lbs [.~ gal [ ] ~t3 [ ] a) ContaJner:
Average Daily Amount: ~o curies [ ] b) Pressure:
Annual Amount: ~;~ ~?~ ~;~2¢,) c) Temperature:
Largest Size Container: "/~ .
# Days On Site .? ~...r-' Circle Which Months: All Yeax. J, F, M, A, M, J, J, A, S, 0;'
9) MIXTURE: List COMPONENT CAS # % WT AHM
chemical comDonent_s or
;' ~ertify under penafly of law, that I have personally examined and"a~"'familiar with the infomadon su~f~/tted on this and
surmised informa~on is true, accurate, and complete.
PRINT Name &/i'itle of Aud3orized Company Representative Signature / Date
..? BAKER. IELD CITY FIRE DEP :ITMENT
HAZmllI~DOUS MATERIALS INVEI~m~ORY
Page~
Business Name ~&~ ~~ /~ Address ~ ~/~ ¢~ ~/Z~/¢
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New~ Addition [ ~ Revision [ ~. ~letion [ ] Check ~ chemi~ is a NON ~OE SECR~ ~ ~DE SECR~
[
2) Common N~e: ~~ ~ 3) ~T ~ (op6on~)
4) PHYS{CAL & H~L~ ..:y,, PHYSICAL H~L~
H~RD CA~GORIES ' Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] lmmedi~e He~h (Ac~e) ~] ~layed He~h (Chronic) [
5) WAS~ C~SSIFICA~ON ~/ .(3-digit code ~om OHS Fo~ ~022) USE CODE
6) PHYSICAL STA~ Solid [ ] Liquid ~ G~ [ ] Pure [ ] M~ure ~ W~te [ ] R~ioa~e {
7) AMOUNT AND ~ME AT FACIU77 ~/ UNITS OF M~SURE., 8) STOOGE CODES
M~imumO~lyAn',ount: /~O I~ [ ] g~ ~ fl3 [ ] .)Cont~rler:
Average O~ Amount: ~ ~ _ curies [ ] b) Pressure:
Annual Amoum: _~ c) Tem~r~ure:
L~gest Size'Container:
¢ Days On Site ~ Circle %~ich Months: All Year. J, F, M, A, M, J, J, A, S, O, N, D
9) MITRE: Ust ~ ~ COMPONEN-f CAS ~ % ~ AHM
chemic~ components or
/
3)
lo) Lo~io. ~ ~ ~ ~j~
,~ CHEMICAL DESCRI~ION
) INVENTORY STA~S: New t ] Addition [ ] Revision ~ ] Deletion [ J Check ~ chemi~ is a NON ~DE SECRet] ~DE SECRET
1
2) Co~mon N.~.: .... ~ ~0 ~ ~ ~¢¢ 3) ~T ¢
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES F~re [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He,th (Ac~e) ~ ~layed He~h (Chron,) [ ]
5) WASTE C~SSIFICATION ~/ (3dig~t code ~'om DHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid ~ L.~quid [ ] Gas [ ~ Pure ~ Mi~ure { ] W~te [ ] Rad~oact;ve [ ]
7) AMOUNT AND TIME AT FACIU~ UNITSj OF M~SURE 8) STOOGE CODES
Cont~ner:
Average D~ty Amount: __ ~ 'cunes[ ] b) Pressure: /
Annu~ Amount: ~ c) Temper~ure:
~gest Size Container:
· Deys On Site .~ Circle~ich Months: ~ J. F. M, A. M, J, J, A. S, ~', N. D
9) MITRE: Mst COMPONENT CAS · %
the three most h~dous 1 )
chemi~ com~nen~ or
~y AHM com~nents '2) [
3) [ )
' ce~ under pen~ of/aw, ~at I have pe~onally exam/n¢ ~d am/~i/i~ w/~ ~e/n/oma n ~is ~d ~1 a~ch~ documenm. / be//eve
submi,~info~a~onis~e, accu~te, and.omplete. " ~
P~ Nam~ Title of Au~orized Company ~epresen~'ve Signa~re ~ '
BAKER, iJ:IELD CITY FIRE DEP , RTMENT
HI - RDOUS MATERIALS INVEi J'ORY
Page;, :" of.z:.
Business Name /~~ /7/7,/ ~ ,// /;::;T ../Z-./'~/~/--~:P Address 'J~{"/ /~/l.~,~,~ C'~" ;.~/~/(e~'/.~/:~7.'~) CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New [~ Addition [ ] Revision [ ] ~letion [ ] Check ~chemi~ is a NON ~OE SECR~~ ~ ~DE SECR~ [ ]
2) Common N~e:__ ~ ~/ ~ ~ 3) ~T · (option~)
Chemi~N~e: ~ ~ (~' ~/~ / ~ AHM[ ] CAS~
4) PHYSICAL & H~L~ ,-;" PHYSICAL H~L~
H~RD CA~GORIES Fir~ [ ] Reactive( ] Sudden Rete~eof Pressure [ ] Immedi~eHe~h (Acme) ~ ~layed He~h (Chronic) [ ]
5) WAS~ C~SS~F~CA~ON ~/ (3-digi~ cuae from DHS Fo~ ~022) USE COOE
6) PHYSICALSI'A~ Solid [ ] LJquia ~ G~ ] Pure~ Mixture [ ] W~te [ ] R~ioa~e [ J
7) AMOUNT AND '~ME AT FACiLI~ UNITS OF M~SURE 8) STOOGE CODES
Average O~ Amount: ___~ curies [ ] b) Pressure:
Annu~ Amount: .~ ~_~_ c) Tem~r~ure:
k L~gest Size Container:
; ~ Days On Site ~Q~ Circle ~ch Months: All Yea~. J, F, M. A, M. J, J, A, ~, O, N. 0
j[ 9) MITRE: List /~~ COMPONENT~ ~lC~l~~ ~~_~)_~CAS~ %~ AHM
J~ the three most h~ardous 1). ~ O, ~e~~ ~
:' c~mmic~ components or
h ~ny AHM components 2) [
~1 3) [ ]
i~ / CHEMICAL DESCRIPTION
J
1)~NVENTORYS'rA~)S: New~Add~tion[ I Revision[ Oelet~n[ ] Check~chemi~isaNON~DESECR~.[~' ~DESECREr'[ 1
2) Common N~e:_~~ ~ ~ ~ 3) ~T ~ (option~)
Chemic~ N~me: ~ ~-'' ;'~' ;~ ~ '';? '~'~ '~ AHM [ ] CAS
4) PHYSICAL & H~L~H ;~HYSICAL H~L~
H~RD
CATEGORIES Fire ~ j Rezctiw ( J S~dd~n Reie~e of Pressure [ ] tmmedi~e He~h (Acme) ~ [~layed He~h (Chron.) { ]
5) WASTE C~SS~FICATION ........ .~' 2 :, / ._~?-dig~t code ~om DHG Form 8022) USE CODE / /
6) PHYSICAL. STA~ Solid [ ~ L.;quid ~ G~ [ ] P,Jre~ M~ure [ ] W~te [ ] Radioa~ive { ]
7) AMOUNT ANO TIME AT FACIU [Y UN~TS OF M~SUR~ 8) STO~G~ CODES
M~imumO.ilyAmount: _ ~0 lbs [ ] g~ ~ ~3 [ ] a) Cont~ner:
Average O~ly Amount: _~ / ~ cunes[ ] b) Pressure: /
Annual Amount: / ~0 c) Temper~ure:
~gest Size Container: ~ ..
-
~ ~y* On S~te _~0~ Circle~ich Months: O, F. M, ~. M, d, d, ~. S..O'.' N. D
9) MITRE: Ust COMPONENT CAS ~ % ~ ~M
the three most h~dou~ 1 ) [
chemi~ com~nen~ or
~y AHM com~nents '2) [ ]
~"f~m'~ under pen~ oi law, ~at I have pe~onally examm~ end am l~ili~ wi~ ~e infoma~n s~ on ~is ~d ~1 a~ch~ documenm. I believe
~ubmi~ .... info~a~on is ~e, accurate, and complete. ~~"- ~~~~~" ....
PRINT Name ~ Title of A~orized Company Represen~ve Si~na~re ~ '
BAKER, IELD CITY FIRE DEPi i ITMENT
H DOUS MATERIALS INVEr I=rORY Page/_ of
Business Name/~;2/"3,,/~'¢-72, ~/'~,~¢,,~-4~ ~/~ Address ~] ~Z)~ ~, T
CHEMICAL DESORI~ION
1) IN~NTORY STA~S: New~ Addition [ ] Revision [ ] ~letion [ ] Check ff chemi~ is a NON ~OE SECR~ ~DE SECR~ [ ]
2) Common N~e: ~ ~ ~ 3) ~T · (opting)
4) PHYSICAL & H~L~ .... :? · PHYSICAL
H~RO CATEGORIES Fir~ [ ~ R~&ctive [ ] Sudden Release of Pressure [ ] lmmedi~e He~h (Ac~e)
5) WAS~ C~SSIFiCA~ON ~ ~'~ .(3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ J G~ [ ] Pure ~ Mi~.r. [ ] W~te
Z) AMOUNT AND ~ME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum O~ly Amount: ~OO i~ g~ l] ifa ti a) Cont~ner:
Average Daily Amount: /~ curies [ ] b) Pressure: /
Annu~ Amoum: ~Oo c) Tem~r~ure:
L~gest Size Container: _
~ Days On Site ~ Circle~ich Months: ~J. F, M. A, M, J. J. A. S. O. N.
D
9) MI~JRE: List COMPONENT CAS ~ % ~ AHM
the three most h~dous 1) ~,~ ~ ¢~/~ ~
chemic~ componen[s or
any AHM com~nents 2). [ ]
3) [ ]
¢ CHEMICAL DESCRI~ION
1) INVENTORY STA~JS: New~ Addition [ ] Revision [ ] Deletion [ ] Check ~chemic~ is a NON TRADE SECR~ ~'~ ~DE SECR~ ~ ]
2) Common Name: ~' ~ ,~__.~¢~ 3) ~T ¢ (option~)
~) PHYSICAL & HEALTH PHYSICAL H~LTH
H~RD
CATEGORIES
Fire
[ ] Reactive [ ] Sudden Relate of Pressure [ ] lmmedi~e He~h (AcCe)
5) WAS~ C~SSIFtCA~ON ~(~digit code kom DHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure [ ] Minute ~ W~te [
7) AMOUNT AND TiME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: /~¢0¢ lbs ~ g~ [ ) '3 [ ] a) Cont~ner:
Average Daily Amount: ~ O curies [ ] .b) Pressure: /
Annu~ Amount: ~ ~ ~ ~. c) Tem~r~ure:
~gest Size Container: ~
¢ g~ On Site _~ Circle'Aich Months. Ail Ye~. J. F. M.
9) MITRE: ~st COMPONENT CAS ¢ % ~ ~M
the three most h~dous 1) [ ]
cherni~ com~nen~ or
~y AHM com~nents '2) [ J
3) [
"~ e~ under pen~ of law, ~at / have pe~onafly exam~n~ ~d am/~]fi~ w]~ We infomaDon subj~'~ on. Wis ~d ~1 a~ch~ documenm. / believe
PRINT ~ame ~ Title o~ f A~orized Company Representa~ve [ ~n~re
BAKERSFIELD CITY FIRE DEP i ITMENT
HAZ3alFIDOUS MATERIALS INVENTORY Page/eof gz
/ CHEMICAL DESCRIPTION
INVENTORY STATUS: New,J~ Addition [ ] Revision [ J Meier,on I ] Check if chemicaJ is a NON TRADE SECRET.~ TRADE SECRET
Common Ne~ne: ~,) /---'~,-~'~' 3) DOT # (optional)
Chemical NarT, e: /'~¢ ~N~'" ~' ~ ~__.-~ Z~..~ O ~. J'~ C~ ....... AHM [ I · CAS # ~/~¢,,/~'- '~/~ ~ ~
4) PHYSICAL & HEALTH .,;~' PHYSICAL H .EA/[,I-H
HAZARD CATEGORIES Fire' I ']: Re'~ctive [ i Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION ~-'~ / - .(3-digit code from DHS Fon'n 8022) USE CODE
PHYSICAL STATE Solid [~' Liquid [ ] Gas [ ] Pure ~X~ Mixture [ ] Waste [ ) Ra~lioactive [ ]
UNITS OF MEASURE 8) STORAGE CODES
AMOUNT AND TIME AT FACIUTY ~,/FO~ ~
Maximum OaJty Amount: lbs ~ ga~ [ I 1'(3 [ ] a) Container: / ~-
Average Daily Amount: --~-~.~0 curies [ ] b) Pressure:
Annual Amount: ,/(//~ 0 ~ _~ c) Temperature:
Largest Size'Container: _
#OaysOnSite _.~'" CircteVVhich Months: ~J, F, M, A, M. J, J, A. S, O, N, D
9) MIXTURE: List ~ COMPONE.~NT CAS # % W'F AHM
the three most hazardous 1 )___~"~ ~'~_J"-J",/_~ ,,~_......__~_ -~_.~ ~0-'6/~.)~ 7 ~'~/'"2 - ~'o~ '~ _?j"-~'~' [ I
chemical components or
any AHM components 2) [ ]
3) [ 1
CHEMICAL DESCRIPTION
1) INVENTORY.STATUS: Ne....w~: Addition [ ] Revision [ ] Deletion { j Check if chemicaJ is a NON TRADE SECRET X] TRADE SECRET
2) Common Ns, rna;____ ~. ~"~ ~C::) 3) DOT # (optioneJ)
4) PHYSICAL. & HEALTH PHYSICAL HE~, .17TH
HAZARD CATEGORIES Fire [ I Reactive [ ~ Sudden Rate&se of Pressure { j Immediate HeaJth (Acme) ,~)(J Delayed He~th (Chronic)
5) WASTE CLASSIFICATION ~ ~'"~/ (3-digit code h'orr, OHS Form 8022) USE CODE //
PHYSICAL STATE Solid ~J Liquid [ t G6~s ~ i Pure ~ Mixture [ I Waste [ ] Radioactive
7) AMOUNT AND TIME AT FACIUI-'( UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ___¢~' O lbs ,,¢~ gat [] ft3 [ J a) Container: / '~-
Average Daily Amount: '~._~ cunes[ ] b) Pressure: /
Annual Amount: ~ ~.{~'~'"~ c) Temperature: ~
Largest Size Container: __~O__ .
# Osys On Site _.~...~ Circle Which Months: All Ye~, J, F, M, A. M. J, J, A. S, '(3'. N, D
9) MIXTURE: Ust COMPONENT # % WT AHM
chemicaJ components or
~qy AHM components '2) [ ]
F'c~r~ under penaJt~ of law, ~at J have pe~onally examm~ ~d am famiii~ wJ~ ~e infoma~on su ~' ~ on ~Js ~d ~J a~ch~ document. I befiev~ ~
PRINT Name ~ Title of A~orized Company Represenm~ve " Sl'g~a~ro ( Da~
BAKER, i IELD CITY FIRE DEP :ITMENT
H~DOUS MATERIALS INVEN"rORY Page.__of :__-
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New,,J~ Addition [ ] Revision [ ] Deletion [ ] Check if chemical is e NON TRADE SECRET ~ TRADE SECRET [ ]
2) Common Name:___ ~-~ ~<./~-)(-, J'~' 3) DOT # (optiona0
ChemicalNam, e: , (..~',,,(2t.x~i)t~U'"'~/ - C~'~.~ ~_-...OJc'~ AHM i ] CAS# '/~7' (~ (.. 7-/ /~'~'
4) PHYSICAL & HEALTH : ~T~ ' PHYSICAL H -,F~A/LTH
HAZARD CATEGORtE~ ; Fire' [ ] R~,~ctive [ ] Sudden Release of Pressure [ ] Immediate Hea~th (Acute) ~,I~-~ Delayed HeaJth (Chronic) [ ]
5) WASTE CLASSIFIC.~T1,.')N .~ ~ / .(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ,~)0 IJquid [ ] Gas [ ] Pure ~)~ Mixture [ ] Waste [ ] RadioactN. e [ ]
7) AMOUNT AND TiME AT FACI~TY UNITS OF MEASURE 8) STORAGE CODES
Ma:f. imum DaJiyAmount: 2~0~ ¢90o lbs ~ gal [ ] ft3 [ ] a) Container:
/
Ave~'age Daily Amount: //'~ ~.?_~_0. curies [ ] b) Pressure:
Annual Amount: ~_~_~.. 0_o._~ c) Temperature: __.~..
LaJ'gest Size'Container.
# Days On Site .~'~.3'"'_ Circle Which Months: ~. F. M, A, M. J, J, A. S. O. N, D
9) MIXTURE: Ust COMPONENT CAS # % WT AHM
(he three most h~.zardous 1) [ ]
chemical compcnen,'s or
&ny AHM components 21 [ ]
' CHEMICAL DESCRIPTION
1) INVENTORY S'~A'mS: New,J.~ Addition [ ] Revision [ ] Deletion [ ] Check if chemioaJ is a NON TRADE SECRET ..~ TRADE SECRET 1' ]
:2')' Corr, m',on Name: ...... ~...,~.~,,~ .,,~/J~ 3) DOT# (optional)
c~.~ioal N~me: ~c~'~O ~ / Cx .-,~ ~.~. 6'0 --~ ~"-~' A,M [ I CAS # ~ ~ - /9--~'
4) PHYSICAL & HEALTit PHYSICAL HEALTH
HAZ. ARD CATEGORIES F!re [ ] Reactive{ ) Sudden Release of Pressure [ ] Immediate Health (Acute) ¢ Delayed Health (Chronic) [ 1
5) WASTE Ct ASSiFICATION ~"'~_2 ,/ (3-digit code from OHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ~ Liquid ( ] Gas [ ] Pure [~ Mixture [ ] Waste [ ] Raaioactive [ ]
7)
AMOUNT
AND
TIME
F ACIL/TY
MITS
OF MEASURE 8) STORAGE CODES
M~tximum D&iiy Arnount:
Average Daily Amount: ~, ~,. ~ cudes [ ] b) Pressure: //
An,~ual Amount: ~__~=~._~ c) Temperature:
Largest Size Container ~ ~ ...
# Days On Site __~--.,~"~ Circle Which Months: ~'~e¢ J. F, U, A, M, J, J, A. S.'O~, N, D
9) MIXTURE: List . COMPONENT CAS # % vcr AHM
chemical components or
any AHM components '2) [ ~
3) [ ]
F'~e~fy under pena]~/ of law, that I have personally examined a~d am/amiliar with the infomatJon su~?~i~i, tted on this and ail attached documents. / believe
submittedinform, tionistTue, a¢cur~te, andcornplete. ~~'.~/~.~~
~ ~Tit/e/f Authorized company Representad-~e ' Signature .~' ' Date
BAKERE iELD. CITY FIRE DEPJ iJiTIVIENT
HA, IIFIDOUS MATERIALS INVEtI'FOFIY Page2~t.__
CHEMICAL DESCRI~ION
1) ~N~NTORY STA~S: New ~] Addition [ ] Revision [ ] ~letion [ ] Check ~ chemi~ is a NON ~DE SECR~ ~ ~DE SECR~ [ J
4) PHYSICAL & HEALTH . ..::- PHYSICAL. HEALTH
HAZARD CATEGORIES - Fire' '[ ]i R'~active [ ] Sudden Release of Pressure [ ] immediate Health (Acute) ~] Delayed Health (Chronic)
5) WASTE CLASSIFICATION ,.~'~ / ,(3-digit code ,'rom DHS Fo,r. 8022) USE CODE
$) PHYSICAL STATE Solid ~ Liquid [ ] G~Ls [ i Pure/l~ M~xture [ J W~te J ] Radioactive [ J
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ¢//g//O0 lbs J~ gal [] ~t3 (] a) Container:
Average Daily Amount: ~ / O ~ canes [ } b) Pressure:
Annue. I Amount: ~-~_o C) Temperature:
Largest Size'Container:
# OaysOnSite ,~ ~'""' Circ!eVVhich Months: ~J, F, M, A, M, J, J, A, S, O, N.
MtXTLJRE: L~s! COMPONENT CAS # % WT AHM
the three most hazardous 1) [ ]
chemicaJ components or
a~y AHM components 2) [ ]
/ CHEMICAL DESCRIPTION
II ~ } .r~,.:~;~TORY ST^~JS: New~] Additicn [ ] Revision [ j Oeletior, [ ] Check ~ chemic~ is a NON ~DE SECR~ ~DE SECR~ ~" ]
4) PHYSICAL & HEAL'ITt PHYSICAL HE(\/L. TH
HAZARD CATEGORIES Fire [ ] Reactive [ i Sudden Re!e~Lse of Pressure [ ] Immediate HeaJth (Acute)
5) WASTE CLASSiFiCATiON --~"~-'/ (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ~ Liquid t I Oa~ [ ] Pure ~1~ Mixture J j Waste [ ) Radioactive
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Max,mum Da, iiy Amount: _.~._.~/00 lbs [] gal [] ft3 [] a) Container: /)....--
Average Daily Amount: '/~ curies [ ] b) Pressure: ' /
Annual Amount: /~ ~...~::) c) Temperature: ~
L.a~'gest Size Container: ~ .
# Days On Site ~.~'~'3'"' Circle Which Months: Q, j, F, M, A. M. J, J. A, S,.'O'i' N. O
9) MIXTURE: Ust COMPONENT CAS # % WT AHM
chemi~ com~nen~ or
~y AHM com~nents '2) [ ]
3) [ ]
1 O) Location ~,/',~f'J..~'~ ,.rl~- C
C&rdJy under penaJty of/aw, that/have personally examined and am ia. mil/al' with the infomad~ed/~~., on lJlis and ail attached documents, l baiieve the
'~ub.~tittedinforrnaD'onisttue, accurate, andcomplete.~ . /~~~,/~/7 ////~.
PRINT Name & Title of Authorized Company Representative ' ' Date
BAKER, i iELD CITY FIRE DEP TMENT
HAZ'A'RDous MATERIALS INVEN-TOI
FlY ,~ Page__oL
Business Name ~/~ /~Z~/~r..~ Z//¢~'-'-~ Address
CHEMICAL DESCRIP3'ION
1 ) INVENTORY STATUS: New J~ Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ,~ TRADE SECRET [ ]
2) Common Name: Fy~o 7'72.0 ~. 3) DOT # (optional)
Chem~ Name: ~/~ T~,~ ~-lo,J 4~,¢?'~. ,~ ~.-~T' AHM [ ] CAS # ,4,'/,~ . .
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ } Reactive~} Sudden Release of Pressure [ ] Immediate Health (Acute) D~ Delayed Health (Chronic) [ }
5) WAST~ CLASSIFICATION ~" ~-~/ (3-digit code from DHS Form 8022) USE CODE ///
6) PHYSICAL STATE Solid [~ Uquid [ I Gas [ ] Pure [~) Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: /.~, .~""O lbs [~ gal [ ] ~t3 [ ] a) Container: ,/ ~--
Average Daily Amount: ~/ ~f~ curies [ ] b) Pressure: /
Annual Amount: ~ c) Tempere4ure: 47/ '
Largest Size'Container:
# Days On Site ..~ ~' Circle W~ich Months: ~ J, F, M, A, M. J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS # % WT AHM
chemicaJ components or
any AHM components 2) [ ]
3). [ ]
CHEMICAL DESCRIPTION
.1 ) iNVENTORY STAT'dS: New ~)~ Addition
2) Common Name: /(/~-'7'Y"} ~' ~-'~ ~, 3) DOT # (optional)
ChemicaJ Name: ~/~nJ"-/M~4/'~/~'~Z~C ~' Z~,,n.~ ~(? FO L~ ~t~ AHM[] CASa ~,//~
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ 1 Reactive ~ Sudden Release of Pressure [ ] Immediate Health (Acute) K] Delayed Health (Chronic)
5) WASTE CLASSIFICATION ·~5~''~ ,/ .(3-digit code from DHS Form 8022) USE CODE //
6) PHYSICAL STATE Solid [~ Liquid [ ] Gas [ ] Pure [,~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACIU'T'Y UNITS OF MEASURE 8) STORAGE CODES
Maximum O@ily Amount: ~'~'~' lbs ~] gaJ [] ft3 [] a) Cont~ner:
Average Daily Amount: ~..~ ~ O cudes [ ] b) Pressure:
Annual Amount: *~3' ~'0'¢ C) Temperature:
Largest Size Container: ,2..-..¢ ~ ·
# Days On Site ..~ ~.3'" Circle Which Months: ~"~1 Ye~J, F, M,' A, M, J, J, A, S,,'O~' N, D
~) M,~R~: -,st COM~.ONENT CAS # ~. ~M
chemi~ com~nen~ or
~y AHM com~nenm '2) [ J
3) [ }
,O) Loc ,on
'" certJl}/ under penalty of law, that I have pe~onafly examined and am familia~ with the infomadon s~ubmitted on this and ail attached documents. I believe th~
submittedin,ormaEonisb-ue, accurate, andcomplete. / /~
PRINT Name ~ Title ~f Authorized Com'pany Representa~'ve - Signature / Date
BAKER, i'E, LD CITY FIRE DEP i :ITMENT
H DOUS MATERIALS INVENTORY
...,~ Page__of__
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New J~ Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [~/J TRADE SECRET
4) PHYSICAL & H~L~ , PHYSICAL H~L~
H~RD CA~GORIES Fire { ] Reactive~ Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e)
5) WAS~ C~SSIFICA~ON ~Z/ (3-digit code from OHS Fo~ 8022) USE CODE
6) PHYSICAL STATE Solid j~l(] Liquid [ ], Gas [ ] Pure [ ] Mixture [~] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~00~'(~ lbs ~)(] gaJ [ ] ft3 [ ] a) Container.
Average OaJly Amount: ~ curies [ ] b) Pressure:
Annual Amount: ~.~ ~ c) Temperature:
I_a~gest Size'Container:
# Days On Site ~ Circle Which Months: ~IIY~a~, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS # % VVT AHM
the three most ha~ardous 1) ,~0 ~/~ ~f'~ ~ ~OA.,~'l I~) ~"' /,~/{3 - ~7- ~_ ~ { ]
chemical components or
any AHM components 2) { ]
3}. [ ]
10) Location ~ ~ ~ ~ '!
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [~ Addition { ] Revision [ ] Deletion [ ] Check if chemicaJ is a NON TRADE SECRET [ } TRADE SECRET [ ]
2) Common Name: ~_ ~.,y~)/~.__/~. '. 3) ~T,(opdon~)
Chemic~Name: ~ ~ ~0~ ~~, ~ ~ ~ ~ AHM[ ] CASe ~/~
4) PHYSICAL'& HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive I~ Sudden Release of Pressure [ ] Immediate heaJth (Acute) [~ Delayed HeaJth (Chronic)
5) WASTE CLASSIFICATION ~' ~" / (3-digit code h'om OHS Form 8022) USE CODE ~///
6) PHYSICAL STATE Solid [~ Liquid [ ] Gas [ ] Pure D(/] Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~¢0"~ lbs [~ gal [] /t3 [] a) Container: / ~-- ·
Average De. il;/Amount: ~.~ ~ ' curies [ ] b) Pressure:
Annual Amount: 5"~ f~.~J;~:~ c) Temperature:
Laxgest Size Container: -' ~'~'" ' ..'
# D~ysOn Site ~'~"" Circle Which Months: J.F.M.A.M.J. J, A. S."~' Ni D
9) MIXTURE: List COMPONENT CAS # % ~ AHM
the three most ha.ze, rdous 1 ). { ]
chemicaJ component~ or
any AHM components '2) [ ]
3)
"cerbb/under pen~ o!/aw, ~at I have pemonally examin~ ~d am
submi~ info~a~on is ~e, accurate, ~d complete.
PRI~ Nam~ & Title of A~orized Company Represenm~'ve Signa~re ) Da~
BAKER. iELD CITY FIRE DEP i FITMENT
HA~-~RRDOUS MATERIALS INVERTORY
..o Pagemof___ I
.~ CHEMICAL DESCRIPTION
~) ,N~NTO~Y S~AT~.S: New l ] Add,,on ~ .~'~,on [ ] ~,e.on [ ] ~.heck. c~ ~.. NON ~ S~C.~ ~ ~ S~C.~
Chemi~N~e: ~ ~O/~--~.~,~~/0, E~E~ ~ AHM[ ] .CAS, ~
4) PHYSICAL & H~L~ . PHYSICAL ~ H~L~
H~RD CA~GORIES Fire ~ Reactive [ ] Sudden R~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ¢~/ (3-di,t.__~d"°m ~S--~'~)% USE CODE //
6) PHYSICAL STA~ Solid [ J Liquid [~ G~ [ ] ~ Pure [ ] M~ure ¢ W~te [ ] R~ioa~e [ J
7) AMOUNT AND ~ME AT FACIU~ UN/TA'M~SURE~'--~' 8) STOOGE CODES
Average Om~ Amount: ~ curies K] b) Pressure: ~ ~
Annu~ Amount: ~ ¢ c) Tem~r~ure: ~ '
~gest Size'Contmner: __~5~
¢ Days On Site ~ Circle~ich Months: ~J. F. M. A. M. J. J. A. S. O. N. D
9) MIXTURE: Ust COMPONENT _ CAS # ~.~W'T~iF AHM
chemical components or
~ny AHM components 2)
3) [ ]
10) Location
/' CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New~ Addition[ ] Revision[ ] Deletion[ ] Check if chemical is a NON TRADE SECRET [ ] TRADE SECRET [ ]
2) Common Name: ~ /4:~ ~" ~'-/~) ~ 3) DOT # (optionaJ)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive (~ Sudden Release of Pressure [ ] Immediate Health (Acute) [~ Delayed HeaJth (Chronic) { ]
5) WASTE CLASSIFICATION .~.// (3-digit code from DHS Form 8022) USE CODE / /
PHYSICAL STATE Solid [ } Liquid ~(~ Gas [ ] Pure [ ] Mixture [~' Waste [ ] Radioactive
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum O,aily Amount: /,,,,~ ~ lbs [ ] g~ [X~ ft3 [ ] a) Container:
Average Daily Amount: ~ O cunest ] b) Pressure:
Annual Amount: /~"~ ~ O c) Temperature:
Largest Size Container:
# Days On Site ~ ~'.t"" Circle W~ich Months: ('A'"~, F. M, A. M, J, J, A. N, D
9) MIXTURE: Ust COMPONENT CAS # % ~ AHM
chemica~ components or
any AHM components '2)
3) [ )
~o) Loc~ion ~
~erbfy under pen~ty of /aw, ~at ~ have pemonally examin~ ~d am f~ili~ wi~ ~e infoma~n S~b~i~ on ~is ~d ~1 a~ch~ documen~ J be)Jeve m~
~ubmi~info~a~onis~e, accumte,~dcomplete. ~~ ~
pRINT Name& Title of A~orized Company Represen~ve / Signa~re / D~
~usine~Name ~ ~uG~s
I , :.'. '~.':"' ~ - - - CHEMICAL DESCRI~ION '-"' "'
1) IN--DRY STA~S: N~~ ~n [: ] Re~n [ ] ~le~n [ ] C~ E c~m~ ~ · NON ~ S~' ~]' ~ S~' [ ]
2)~m~nN~: A~YT,~R . 3)~T~(o~ ~]~ 1~
4) PHYSIC~ & H~ PH~IC~ H~
H~DCA~GORIES Fire~ Re~] Sudden Re~e of Pressure {~) Im~eHe~e)~' ~He~(Chmn~)~
WAS~ C~SSIFICA~ON .(~E ~de~m ~s:'F°~ 80~) USE CODE:
6) PHYSICALSTA~ Solid [ ] ~qu~ [ ] G~ -~ure~ M~re [ ] W~te [ ] ~.[ ]
7) AMOUNT AND'~ME'AT FAC[~ UNITS OF M~SURE 8) STO E ~DEs
M~mum O~N'~unt:' 60 '" [~ [ ] g~ [ ] ~3~ a) ~n~nec '. 04
Average D~N ~ount: ~ cudes [ ] b) Pressure: .... ~ -
~nua ~unt: ' . . l~0 c) Tempera: 4
~gest Size'Cont~ner:
· Da~Ons~e 3~ Ci~le~ich Months: ~llYe~.)J. F, M, A, M, J, J, A. S, O. N, D
9) MITRE: ~st COMPONE~ CAS · % ~ ~M
the three most h~dous 1). [ ]
chemi~ com~nen~ or
:J ~y AHM ~m~nen~s 2}
J
.. . 3) [ ]
~ . '~ ::..~ ....... ' . ,/~ .... '~.' CHEM!CALDESCRI~ION
1) IN~NTORY STA~S: New~="~'~i~n'~'~] Re,sion [ ] ~letion ( J Check ~chemi~ is ~ NON ~OE S~R~ '[~J '~E S~R~ [ J
2) CommonN~e: AQUA ~ONIA" ' 3) ~r~ (o~ NA 2672
Chemi~ Name: ~ONIUM" HYDROXIDE AHM [ ] CAS · 1336-21-6
H~O CA~ORIES ... Fi~e k; . . Rea~ive'[ ] '~ Sudden Rele~e of Pressure [ ] l~medi~e He~h (Ac~e)
5) WASTE C~SSIFICA~ON ,(~ig~ Cod~ ~om OHS Fo~ S022) USE CODE 43
6) PHYS[CAtSTA~ Solid [ ] ~quid ~] G~ ,[ ] Pure { ] Mimure ~ W~te [ ] Radioa~Ne [ ]
7) AMOUNT AND TIM5 6T FAClU~' . UNITS OF M~SUR5 8) STOOGE CODES
'' M~im~m O~ly Amount;' 25 lbs [ J ~ [~ ~3 [ ] a) Cont~ne~ 10
Average O~ly Amount: .. 15 cude~ :[ ] b) Pressure: 1
. ~gest SizeCont~ner:
~ Oa~ On S~e 365 Cimte ~ich Months: (All Ye~.)j, F. M. A. M, J. J. k S, O. N. D
9) MITRE: Ust COMPONENT CAS · % ~ .... ~M
themreemosth~dous ....... 1)"--~ON[~ ........... t ................. 7~64-4]-7. ~ '[ ]
chemi~ ~m~nm o~
PRI~ N~e & ~e of ~odz~ Comfy Represen~e ~ign~m ~ /
1) I~TORY STA~S: N~ ~n { ] Re~n [ ] ~le~n [ ] C~k ~ c~m~ ~ a NON ~ S~' ~Z' ~"S~R~ [ ]
4) PHYSIC~ & H~ PH~IC~ H~
H~O CA. CURIES Rte { ] Re~ [ ] Sudden Re~e of Pressure [, ] Im~e He~ ~e) [ ]
6) PHYSICAL STA~ Solid [ ] Uqu~ ~] G~ [ ] · , Rure [ ] M~m ~ W~te [ ] ~.[ ]
7) AMOUNT AND'~ME AT FACI~ '" UNITS OF M~SURE 8) STO~G~ CODES
AvemgeOmW~oum: ]~ cudes ( ] b) Pressure: ]
. Annu~ ~unt: ,~h~ c) Tempera:
%} ~g~t Size'Cont~ner: ! ~0
~ Da~o~S~e ~ Ci~le~ichMomhs: (AIIYe~.) J. F, M, A, M, J, J, A. S, O. N, D
9) MITRE: ~st COMPONE~ CAS · %
the three most h~dous 1) [ ]
~ chem~ com~nen~ or
;~ ~y AHM ~m~nen~s 2).
.. 3). []
DESCRI~ION
1) IN~NTORY STA~S: New~"~dki~ (>] Re.sion { ] ~letion [ ] Che~ E chemi~ is ~ NON ~OE S~R~-~] '~E S~R~ [ ]
2) Common N~e: BA~R ~OND' "' 3) ~T · (o~)
Chemi~ Name: PHENOLIC" DOATER CRYSTALLINE SILICA AHM [ ] CAS ·
4) PHYSICAL & H~L~ PHYSICAL , H~
H~D CA.CURIES .... Fi~e [. ] Reamive [ ] '~ Sudden Rele=e of Pressure [ ~ Immedime He~h (Acme) ~ ~layed He~ (Chron.)
5) WASTE C~SSIFICA~'~' ':' (~ig~ c0de'~om OHS'Fo~ 8o~2) USE CODE 43
5) PHYSICAL STA~ Solid ~) Dquid { ] G~ ,[ ] Pure ;{ '] Minute ~ W~te [ ] RadioamNe
7) AMOUNT AND TIME AT FACIU~' UNITS OF M~SURE 8) STO~GE CODES
.... u~imum OailyAmount:' ,~0'~000 lbs ~l ~ [ ] ~3 [ ] a) Cont~ne~ 12
Average Oaly Amount: .. 15 t 000 cu~es [ ] b) Pressure: ] '
~ oa~ On S~e 365 ' Circle ~ich Months: (All Ye~ J,' F. M, A. M, J, J, ~ S, O.
chemi~ com~n~ or
-': ~ - * ' CHEMICAL DESCRI~ION
1) 'IN~ORY STA~S: New ~] A~n [ ] Re~n [ ] ~le~n [ ] C~kE c~m~ ~a NON ~ S~*~* ~S~ [ ]
C~N~e: CRY~AT,T,T~ ~TLTCA .~M [ ] C~e [4808-60-7
4) P~YS~C~ & H~m PH~C~ H~m
H~O CA~GORIES Rte [ ] Re~ [' ] S~den Re~e of Pressure [- ] Im~e He~ ~e) ~] ~ He~ (Chron.) [~ *
6) PHYSICALSTA~ Solid ~3 Uqu~ [ ] G~ [ ] . Rum ~] M~m [ ] W~te [ ]
7) AMOUNT ANO-~ME'AT FACI~ UNITS OF M~SURE 8) STO~G~ CODES ' ~'~' '"' '~ ..=:~:_.......
a~mumO~N'~u~:'[r~00,'0~0 [~ E] g~ [ ] ~3 [ ] a)~n~nec .
Avemge'Oa~ ~oum: 900 ~ OOO curies [ ] b) Pressure:
~nua ~unt: . . .~ r 000 ~ O00 c) Tempera:
~gest Size'Cont~ner: 3 ~ 000
· Da~O~S~e 365 Ci~le~ich Months: (AIIYe~ J. F, M, A, M, J, J, A, S, O. N. D
9) MITRE: Ust COMPONE~ CAS ·
the three most h~dous 1) SILICA CRYSTALLINE QUARTZ 14808-60-7 100
chem~ com~nen~ o¢
~y ~M ~m~nents 2). { ]
.. . 3) []
10) toc~ion RTITT,DTNG "R"
CHEMICAL.DESCRI~ION
2) Common N~e: DIATO]~CEOU~' EARTH (DE~ 3) ~T · (o~)
Chemi~ Name: SILICA AHM [ ] CAS ·
4) PHYSICAt & H~L~ PHYSICAt H~
H~O CA~GORIES ..... Fire. [ ] . Rea~ive [ ]" Suddeo Rele~e of ~res~ufe [ ] ~mmedi~. He~h (Ac~e)~]
5) WASTE C~SS~FICA~'~' "" .(~Jg~ Cod~'~om OHS'~o~ 8022) USE COOE 99-'-'FILTERING AGENT
6) PHYSICAtSTA~ Solid ~ Uquid [ ] G~ .[ ] Pure k] Mimure [ ] W~te [ ] Radioa~ [ ]
7) AMOUNT ANO TIME 6T FAC[U~' ' UNITS OF M~SUR5 8) STO~G5
'."' M~imUmOmlyAmount: '3~000 tbs ~] G~ [ ] ~3 [ ] a) Contmnec 12
~ Da~On'S~e 365' Cim~e~ich Months: (AIIYe~ J. F, M, A, M, J, J, ~ S, O. N,
9) MITRE: Ust COMPONENT CAS · % ~ ..... ~M
the ~ree most h~dous ...... 1)-"D~ATOMSCEOUS EAR~ ....................... 68855-54-9 l~h~' ' [ ]
chemi~ come.nm o~
PRI~ N~e & ~ffe of ~ofiz~ Com~y Represen~e Sign~ ~ / Da~
' "' CHEMICAL DESCRI~iON ,. .... · ':*:,t ....
1) IN~TORYSTA~S: N~] A~n[ ] Re~n[ ] ~le~n[ ] C~'Ec~m~aNON~S~'[~ ~S~ [ ]
C~m~ N~e; .~M [ ] C~
4) PHYSIC~ & H~ PH~IC~ H~
H~D CA~GORIES Rte [ ] Re~ [ ] S~den Re~e of Pressure ~ ] Im~e He~ ~e) ~]
6) PHYSICALSTA~ Solid [ ] Uqu~ ~] G~ [ ] Pure [ ] M~re ~] W~te [ ] ~.[ ]
7) AMOU~ AND-~ME AT FACI~ UNITS OF M~SURE 8) STOOGE ~DES
Average D~N ~oum: 2 cudes [ ] b) Pressure:
~nu~ ~unt: ' 15 c) Tempera: ~ -
~gest Size'Cont~ner: ~ 6 OD.
~ De~Ons~e 365 Ci~le~ichMonths: (AIIYe~) d. F. M. A. M, J. J. A. S, O. N. D
~ 9) MITRE: Ust COMPONE~ CAS · % ~ ~M
the three most h~dous 1) ~T,~ ~T,~RT~ 75-09-2 R~ [ ]
~ chem~ com~nen~ or
~y AHM ~m~nents 2)- ~O~ 10 [ ]
1) IN~NTORY STA~S: New'{~]"-'~i~n' ~'~] Re,sion [ ] ~letion [ ] Check ff chemi~ is e NON ~OE S~R~
2) Commorinse: [~O A0 '~ 3) ~T · (o~)
Chemi~Name: ~~"G~YCO~ ~O~O~ ~A AHM[ ] CAS~ 111-76-2
4) PHYSlC~ & H~L~ PHYSICAL
H~D CA~GORIES. .. Fi~e. ~] .. Re~ive'[ ] -:. Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~] ~layed
5) WASTE C~SSIFICA~ -' (~igA C0d~'ffom DHS'Fo~ 8022) USE CODE ' '~3
6) PHYSICALSTA~ Solid [ ] . ~quid ~X G~ [ ] Pure ~] Minute [ ] W~te [ ] Radioe~Ne [ ]
7) AMOUNT AND TIME AT FAGIU~' UNITS OF M~SURE 8) STOOGE CODES
'" M~imumOailyAmount: ~0 lbs [ ] g~ ~] ~5 [ ] a) Cont~nen
Average Omly Amount: . ~0 cune~ [ ] b) Pressure: I
. .~gest S~e Cont~ner:
~Da~OnSAe A~5' ' Circle ~ich Months: (AIIYe~ J.'F. M. A. M. J. d. ~ S. O. N. D
9) MITRE: ~st COMPONENT CAS · %'~'
chemi~ ~m~nen~ or
) ce~ unde~ pen~ of law, ~t I h~ve pe~on~ e~in~ ~ ~ f~ili~ wi~ ~e infom~on submiff~ on ~is ~ ~1 ~.d~e~7.
2) ~m~nN~:' ~GNE~tUM OXTDR 3) ~T · (o~
C~ N~e: .~M [ ] C~
4) PHYSIC~ & H~ " PH~IC~ H~
H~D CALORIES Rte [ ] Rea~ [ ] S~den Red.eof Pressure [- ] Im~eHe~ ~e)~
6) PHYSICAL STA~ Solid~ Uqu~ [ ] G~ [ ] ~ure ~ M~re [ ] W~te [ ] ~.[ ]
7) AMOUNT AND~ME'AT FACI~ UNITS OF M~SURE 8) STOOGE ~S
M~mum ~N'~u~t:' ~00 I~ g~ [ ] fi3 [ ) ~ ~n~nec ':99 CA~BOA~
Average ~N ~oum: ~ 0 cudes [ ] b) Pressbre:
~nu~ ~unt:..' ...... !00 c) Tempera: 4
~gest Size'Cont~ne~: ] ~
~Da~O~SRe 3c~ Ci~le~ich Months: ~llYe~.)J, F. M, A, M, J. J, A. S, O. N, D
9) MITRE: ~st COMPONE~ CAS ·
the (hree most h~dous ~) ~GNESIUM OXIDE 1309-48-4
chem~ com~nen~ o~
~y ~M ~m~nen~s 2)
1) IN~NTORY STA~S: New~:~'"~k~n"~':'] Re.sion ( ] ~letion ( I Check ff chemi~ b m NON ~0E S~R~
2) Common N~e: N~A '-' 3) ~T · (o~
Chemi~N~e: GLYCINE, CA~OXY~THYL, TRI$ODIU~ SALT., MONOHYD~T~M[ ] CAS~ 18662-5~-8 ,
4) PHYSIC~ & H~L~ PHYSICAL
H~D CA~GORIES Fire [ ] Rea~ive [ ] '- Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) [ ] ~layed He~ (Chmn~) [ ]
5) WAS~C~SSIFIOA~'~" ':': (~igkcodbffomOHSFo~8022) USECOOE "' 43
6) PHYSICALSTA~ Solid ~) . Uquid [ ] G~ [ ] Pure~ Minute [ ] W~te [ ] Radioa~Ne [ ]
7) AMOUNT AND TIME 6T FACIU~ ' UNITS 0F M~SURE 8) STOOGE CODES
'." M~imUm O~ly Amount: ~ lbs ~ ~ { ] ~3 [ ] a) Cont~nec 12
Average Oaly Amount: 600 cunes[ ] b) Pressure:
.~gest S[Z~ Cont~nec 5 O
~Oa~OnS~e ~5 Circ~e~ich Months: (~lYe~.) J.'F. M, A. M. J. J. ~ S. O. N,
9) MITRE: ~st COMPONE~ CAS ·
the ~me most h~dous ....... 1)'7 ....................... ~ ~ .......................................
chemi~ ~m~nenm o~
CHA~S~'-~CE SR. COMPLETIONS SPECIALIST
RI~ N~e & ~Ee of ~odz~ Com~y Represenm~e
~t CHEMICAL DESCRI~ION '- ' ..... "
C~N~e: OXYG~ .~M [ ] C~ 7782-44-7
4) PH~IC~ & H~ PH~iC~ H~
H~DCA~ORIES Rte ~ Res~[ ] Sudden Re~ of Pressure X~ Im~eHe~e) [~ ~He~(Chmn~)
6) PHYSICALSTA~ Solid [ ] Uqu~ [ ] G~ ~3 -. Rure ~ M~re [ ] W~te [ ]
FACI~
7)
AMOUNT
AND~MEAT
STOOGE ~S
M~mumO~¥~u~:' ~0 I~ [ ] g~ [ ] ~3 ~ a) ~n~nec ':
A~mge~oum: · 60 cudes [ ] b) PressUre: ] ' -.
~g~t Size'Cent~ner: ~ 0
· O~ on S~e ~6~ ci~{e ~ic~ Months: (A~I Ye~.)J. F. M. A. M. J. J. A. S. O. N. D
9) MITRE: Ust COMPONE~ CAS · %
the three most h~dous 1) OX~G~t COZ~S~D 7~R~-&4-? ]~ [ ]
chem~ com~nen~ or
~y AHM ~m~nents 2)- [ ]
. 3) []
10) Loc~on 9UZ~DZ~G "A" .SOU~SS~ CO~
1) IN~NTQRY STA~S: New'~'"'~ ~';] Re,sion [ ] ~letion [ ] Check ~ che mi~ is ~ NON ~DE S~R~-[~
2) Common N~e: ~0~ 3) ~T · (0~ TT~-
Chemi~ N~e: ~U~SD' 2~O~UN GAS AHM [ ] CAS · 74-98-6
4) PHYSIC~ & H~L~ PHYSICAL
H~O CA~GORIES ..... Fi~e .~ .. Rest/ye'[ ] '- Sudden Rele~e of Pressure ~ Immedi~e He~h (Ac~e) ~ ~layed He~ (Chron,) [ ]
5) WASTE C~SSIFICA~'N' "" (~ig~ Code from OHS Fo~ 8022) USE CODE ~" '
6) PHYSICALSTA~ Solid [ ] . U~uid~ G~ [~ Pure ~ Mi~ure [ ] W~te [ ] R~dio~e [
7) AMOUNT AND ~ME ~ FACIU~' UNITS OF M~SURE 8) STOOGE COOES
.... M~im~mo~lyAmount: 50~ ~bs [ ] G~ ~3 [ ] a) Cont~nec 03
Average O~lyAmount: ._ .35Q curies [ ] b) Pressure:
~ges~ S~ont~ner: 500
~ De~On'S~e 3R'S'" Circle~ich Months: ( ~lYe~,)J. F. M. A. M, J, J. ~ S, O, N, O
~) MITRE: Ust COMPONE~ CAS · %
the ~ree most h~dous ........ 1)"; ............................. t ............................................... : = ' [ ]
chemi~ ~m~nm or
Rt~ Name & ~ffe of ~odz~ ~m~y Represenm~e Signa~m
4) PHYSIC~ & H~ PH~IC~ H~
H~D CA~GORiES ~re ~ Re~ [ ] S~den Re~ of Pressure [- } Im~e He~ ~e)~ ~a~ He~ (Chron.)
6) PHYSIC~STA~ Solid [ ] ~qu~ ~] G~ [ ] Rure [ ] M~e~ W~te [ ] ~.[ ]
7) AMOU~ ANO-~ME AT FAC~ UN~S OF M~SURE 8) STOOGE ~S
Average D~ ~um: 30 cudes
~nu~ ~ount:_ 120 c) Tempera:
~gest Size'Cont~ne~:
· O~ On S~e ~5 Ci~le ~ich Months: (All Ye~ J. F. M, A. M. J, J, A. S, O. N, D
9) MITRE: Ust COMPONE~ CAS
lhethreemosth~dous I) C-9-C13 SATU~TED HYDROCA~ON 64741-41-q R5
chem~ com~nen~ or
~y ~M ~m~nents 2). ETHYL - BENZENE 100-41-4 .05
.. 3) XYLENE 1330-90-7 1.0
10) Loc~ion BUILDING "A" '~ '
X~ '" : .~.' . .. CHEM!CAL.DESCRImlON
1 ) IN~NTORY STA~S: New'['~' '~'d~n' i~']
2) Comm0nN~e:SODIUM PE.~O~TE MONOHYDRATR 3) ~T · (o~
Chemi~ Name:PE~ORIC ~CID, SODIUM SALT MONOHYD~TE AHM [ ] CAS ~ 103322-33-9
4) PHYSICAL & H~L~ PHYSICAL H~
H~D CA~GORIES .... Fi~e. ~ . Rea~ive'[ ]
5) WASTE C~SSIFICA~N .... ' (~ig~
6) PHYSICAL STA~ Solid ~) ~guid
7) AMOUNT AND TIME 6~ FACIU~' UNITS OF M~SURE 8) STOOGE CODES
'." M~imum Daily Amount: ~00 lbs
Average O~ly Amount: ~ cunes
· ~gest $(z~ Con~ner: 50
~ Oa~ On S~e 365 Circle ~ich ~onths: (AIlYe~
9) MITRE: Ust COMPONENT CAS · % ~ ....
the ~ree most h~dous ...... ~)'" ~DIUM" PE~O~TEt tMONOHYD~TE .............. '10,3322-33-9 _ q4-q~
chemi~ ~m~nm or
~y
~RI~ N~e & ~e of A~odz~ Com~ Bepresen~e Sig~m
~usine~Name BA~R HUGHES ~NTEfi AddA~";~:':~{~-5'i:~"~g~$:N CT.
'" .... CHEMICAL DESCRI~iON ':'
1)IN~TORYSTA~S: N~[~ ~n[ ] Re~n[ ] ~le~n[ ] C~'ffc~m~aNON~S~'~] ~S~R~ [ ]
2) ~m~nN~: ~ MIX 3) ~T · (o~
C~m~N~e: GAOU~D G~U~A~gD ~S~ - EU~ACg S~AG ~M [] C~
4) PHYSIC~ & H~ PH~IC~ H~
H~D CA~GORIES Fire [ ] Re~ [ ] Sudden Re~e of Pressure [. ] Im~e He~ ~e) [~
6) PHYSlCALSTA~ Solid ~] Uqu~ { ] G~ { ] Rure {~ M~re [ ] W~te [ ]
M~umO~u~:' [8~,000 I~ [Z] g~ [ ] fi3 [ ] a)~n~oe~ ' .
Average D~N ~ount: [~b ~ UUU cudes [ ] b) Pressure: [ -
~nu~ ~ount:.. . [86 ~ 000 c) Tempera: 4 -
~gest Size'Cont~ner: 2 ~ 000
· DA~Ons~e ~G~ Ci~te~ich Months: (~llYe~.) J. F. M. A. M. J. J. A. S. O. N. D
9) MITRE: Ust COMPONE~ CAS · %
the three most h~dous 1)
chem~ com~nen~ or
; ~y AHM com~nents 2). [ ]
3)
CHEM!CAL DESCRI~IQN
. 1) IN~NTORY STA~S: New'[~":~i~n'~';] Re,sion { ] ~letion ( ] Check ~ chemi~ ~ a NON ~OE S~R~ ~] '~E SECR~ [ ]
I
Chemi~NAme: Z~ ~U~ AHM[ ] CAS~ [[38-66-2
4) PHYSICAL & H~L~ PHYSICAL H~
;~ H~D CA~GORIES .... Fire Ix] Restive [ ] - Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acute) [ _] ~layed He~ (Chron,) [ ]
5) WASTE C~SSIFICA~'N' "' (~ig~ Code ~om DHS'Fo~ 8022) USE CODE ~ ~ '
I 6) PHYSICALSTA~ Solid X J Uguid ~ ] G~ [ ] Pure [ J Minute [~ W~te [ ] RsdioamNe [ ]
7) AMOUNT AND TIME ~T FAClU~' UNITS OF M~SURE 8) STOOGE CODES
'."" M~imUmOailyAmount: [¢000- lbs ~] G~ [ ] ~3 [ ] a) Cont~nec [2
Average Oaly Amount: .. [ ~ 000 cunes[ ] b) Pressure: ~ '
~gest Size Cont~ner:
~De~OnSAe 3~5" ' Circle ~ich Months: (AIIYe~) J. F. M. A. M. J. J. ~ S. O. N. D
9) MITRE: Ust coMPONENT CAS ~ % ~. .~M
the ~m*emost h~dous ...... 1)";~AN GTTM · -~ ................ ] ]-q-R-RR-,? 100 [ ]
chemi~ ~m~nenm or
ce~ u~er p~n~ o~ law, ~at I have pe~on~ly e~m~ ~ ~ f~ili~ wi~ ~e infomadon sub~n ~is ~ ~l~g~umen~-
CHA~-~'~Y~NCE SR. COMPLETIONS SPECIALIST
PRI~ N~e & Uge of ~odz~ Com~y Represenm~e
' "- "-' :-" : CHEMICAL DESCRI~ION '-'
C~m~N~e: O~GAR[C ~D .~M [ ] C~e
4) PHYSIC~ & H~ ' PH~IC~ H~
H~D CARRIES Rre [~ Re~ [ ] S~den Re~e of Pressure [. ] i~e He~ ~e) ~ ~ He~ (~mn~) ~ '
.{~ ~de ~m ~S' Fo~ 80~) . USE CO~: ~ 3
6) PHYSIcALSTA~ Sol~ [ ] ~qu~ [~ G~ [ ] Rure [ ] M~m ~ W~te [ ] ~.[ ]
7) AMOUNT AND'~ME AT FACI~' UNITS OF M~SURE 8) STOOGE ~DES
M~mum ~'~unt:' [00 ' I~ [ ] g~ ~ ~3 [ ] e) ~nec · 07--[0
AvemgeO~o.u~: .55 cudes [ ] b) Pressure: __
~ges~ Size'Cont~ner: 55
· 0~ on'S~e 365 Ci~le ~ich Months: (All Ye~. J. F, M, A, M, J, J, A, S, O, N. D
9) MITRE: Ust COMPONE~ CAS ~ %
the threemost h~dous 1) ~Y~ OC~YRO~' [04-76-7 5-
chem~'com~nenm or
~y AHM ~m~nen~s 2) [SO~O~Y~ A~COHO~ 67-63-0 [-[0
...... . ~). ~O~A~GY~ A~COHO~ [07-[9-7 [-[0 [
1) IN~NTORY STA~S: New'~":~i~n"[';] Re,sion I ] ~letion [ ] Check ~ chemi~ ~, NON ~DE S~R~ '[~
Chemi~ N~e: OR~[C A~[D AHM [ ] CAS ·
4) PHYSICAL & H~L~ PHYSICAL H~
H~OCA~GORIES.' F{re.~] .. Res~Ne( ] '- Sudden Rele~e of Pressure [ ] (mmad[~aHa~(Ac~a) ~] ~yedHa~(Cbmn~)
5) WAS~ C~SSIFICA~'~ ..... ~': (~ig~ Cod~ from OHS Fo~ 8022) USE CODE ~ ~' ,
6) PHYSICALSTA~ Solid [ ] . ~quid [~ O~ [ ] Pure ~] Minute [ ] W~te [ ] Radio~Ne [
7) AMOUNT AND TIME ~T FACIU~' UNITS OF M~SURE 8) STOOGE CODES
'.'-'M~imbmo~I~Amount:' ~ lbs { ] ga ~] ~3 [ ] ~)Con[~nec 07
Average Omly Amount: .~ ~0 . cude~ ~[ ] b) Pressure:
: ~gest S~z~ Cont~ne~ 5 5
9) MITRE: ~st COMPONE~ CAS · %
chemi~ ~m~nen~ o~
'Rl~ N~e & ~Ee of ~odz~ ~m~y Bepresenm~e Sig~m ~ /
C~m~ N~e: ORG~IC BLEND .~M [ ] C~ · 67891-77-6
Average Om~ ~oum; 40 cunes[ ] b) Premium; 1 ' -
~ges~ Size'Con~nef: 55
· Daw On S~e 365 Ci~le ~ich Months: (All Ye~, J. F, M, A. M. J, J, A. S. O, N. D
9) MITRE: ~st COMPONS~ CAS ·
me three most h~dous ~) ARO~TIC PETROLEUM SOLVENT 67891-77-6 40-44
~y AHM ~m~nen~s 2)- ~ ]
2) Commo~ N~e; A..120 SEQUESTERING AGENT 3) ~T · (o~
Chem~ N~e: ORG~IC ACID' AHM [ ~ CAS ~
4) PHYSICAL & H~L~ PHYSICAL
H~OCA~GORIES. .... Fite.[.] .Re~e[ ]-SuddenRele~eofPressure { ] Immedi~eHe~(Ac~e) ~] ~layedHe~(Chmn~) [ ]
~ 5) WAS~ C~SSIFICA~'~' .... :' (~ig~ ~od~'~om DHS' Fo~ 8022) USE CO~E ' ' ~ 3
8) PHYSICAL STA~ Solid {~ . U~uid { ] G~ [ ] Pure ~} Minute [ ] W~te { ] R~dio=~e
7) AMOU~ AND TIME ~T FACIU~' UNITS OF M~SURE 8) STOOGE COOES
'-""M~mQ~ O~lyAmount: 200 lbs ~X G~ { ] ~3 [ ] a) Contmnec 12
Average Oaly Amount: ._ 100 cu6e~ :[ ] b) Pressure:
· ,~ges~ S~ze Cont~nec
~OawOn'S~e 365" Cirde~ichMonths: (AIIYe~.~. F.' M. A. M. J. J. k S, O. N. D
9) MITRE: ~st COMPON~ CAS · ~ ~-' - ~M
the~reem0sth~doas ....... 1)":"C-IT'RtG ACI-D ...... ~ ................................... 77-92-9 -- ~00;~ '( ]
chemi~ ~m~nenm or
~1~ N~e & UHe of ~ofiz~ Com~yRepresenm~e Sign~ ~~
2) ~m~nN~: ~-[70 ~D~OC~O~[C ~C[D 3) ~T · (o~
C~m~N~e: [~O~G~[C AC[D~ NU~[A~[C AC[D~ ~D~OUS EYD~OGS~ .~M[ ] C~e 7647-0[-0
4) PHYSIC~ & H~ ' PH~IC~ H~
H~D CA~ORIES Rte [ ] Re~ ~] Sudden Re~e of Pressure [- ] Im~e He~ ~e) ~ ~ He~ (Chron.) [ ] '
6) pHySIcALSTA~ Solid [ ] Uqu~ [~ G~ [ ] Rure [ ] M~re ~ W~te [ ]
Average O~ ~oum: ~0 cudes [ ] b) Pressure:
. ~nu~ ~unt:" ' .55 c) Tem~m:
~gest Size'Confiner:
· Oa~ ons~e 365 Cimle~ich Months: (All Ye~. J. F. M. A. M. J. J. A. S. O. N. D
9) MITRE: Ust COMPONE~ CAS ·
the three most h~dous 1}. ~D~O0~O~IC ACID 76~?-01-0 5-28 [
chem~'com~nen~ or
~y AHM ~m~ents 21
1) IN~NTORY STA~S: New"~"~i~n' ~';] Re,sion [ ] ~letion [ ] Check ~ chemi~ ~, NON ~DE S~R~ ~ '~E SECR~ [ ]
2) Common N~e: ~-6.~0 ~O~U~ C~O~D~ 3) ~T · (o~
Chemi~N~me: ~O~UN C~O~D~ AHM[ ] CAS~ ~2~25-02-9
4) PHYSICAL & H~L~ PHYSICAL H~
H~OCA~GORIES.' Fire.[.] . Restive[ ] '- Sudden Rele~e of Pressure [ ] Immedi~eHe~(Ac~e) ~] ~layed~e~(Chmn~)
5) WAS~ C~SSIFICA~'N' ' ':" (~ig~ Cod~ ~om OHS Fo~ 8022) USE CODE ' ~3
6) PHYSICAL STA~ Solid ~ . Uquid [ ] G~ [ ] Pure ~J Minute [ ] . W~te [ ] R,dio,~Ne [ J
7) AMOUNT AND TIME ~T FACIU~' UNITS OF M~SURE 8) STOOGE COONS
'."' M~i~m O~lyAmount:' '~500 lbs ~] ~ [ ] ~3 [ ] a) Cont~nec
Average Oaly Amount: .. 750 cudes [ ] b) Pressure: ~ ' "
. .~gest'S{ze ~ont~ne~ 50
~D~On-S~e 3~'5' Cirde~ich Months: (AIIye~ J.'F. M. A. M. J. J. ~ S. O. N. D
9) MITRE: Ust coMPoNE~ CAS · % ~ ~M
chemi~ ~m~nenm or
~Ri~ N~e & ~Ee of ~odz~ Comfy Bepresen~e Sign~
' · ' "CHEMICAL DESCRI~ION "
2) ~m~nN~: S-40 P~HYD~TING FLUID FOR HEC 3) ~T N (o~
C~m~N~e: TRIHYDRIC ALCOHOL
4) PHYSIC~ & H~ ' PH~lC~
H~D CA~ORIES Rm [ ] Re~ [' ] S~den Re~e of Pressure [. ] Im~e He
6) PHYSICALSTA~ ~lid [ ] Uqu~ {~ G~ { )
~gest Size'Oont~ner: 5
· O~W O~'S~e 365 Ci~le ~ich Months: (All Ye~, J, F, M. A. M, J, J, A. S, O. N. D
9) MITRE: Ust COMPONE~ CAS
%he throe most h~dous 1) G~C~ 56-R~-~ 99.
chem~ com~nen~ or
~y ~M com~nents
10) Loc~ion BUILDING ."C" ' -- - :,. '.-..
1) IN~NTORY STA~S: New"~'j'":~6n' ~':] Re,sion [ ] ~letion [ ] Che~ ~ chemi~ is a NON ~OE S~R~ ~ '~E
2) Common N~e: S-.90 MUTUAL ';SOLVINT ~) ~T · (o~
Chemi~N~e: ORG~IC S'OLVINT~ GLYCOL ETHER AHM~ ] CAS~ 111-76-2
4) PHYSIC~ & H~L~ PHYSICAL H~
H~QCA~GORIES. Fire.[ ]. Re~e[ ] '- Sudden Rele~e of Pressure [
5) WAS~ C~SS~F~CA~'6~ ":'; (~ig~ Cod~'ffom OHS' Fon~ 8022) USE COOE '4'3
6) PHYSIOAL SIA~ Solid [ ] . Uquid ~ G~ [ ] Pure ~ Mimure [ ] W~te [ ] Radioa~Ne [
7) AMOUNT AND TIME ~T FACIU~' UNITS OF M~SURE 8) STOOGE COOES
'-'-'M~imUmOdlyAmount: '110 lbs [ ] g~ k] ~3 [ I a)~ntdnen 07
Average OalyAmount .~ 70 cune~ ,[ ] b) Pressure: 1"
~Da~On'S~e 36'5' Cirde~ichMonths: (AIIYe~.~. F. M. A. M. J. J. k S. O. N. D
9) M~RE: uSt COMPONE~ C~
the m~e most h~do~s ....... ~).-;~TH~LENE. GLYCQL-~NOHUTYA - E~ER .............. 1.1.1~76-2 .. 100
chemi~ ~m~nen~ or
'Rl~ N~e & ~ffe of ~o~z~ Comfy Represen~e ~ig~m
' ' ~ .... CHEMICAL DESCRI~iON :' ' " .......
2) ~,U.~: 9-643 9ZOC[DD 3) ~T~ (o~
C~m~N~e: O~GA~[C ~D .~M [ ] C~
4) PHYSIC~ & H~ ' PH~IC~ H~
H~DCA~GORIES Rte [~ Re~[ ] Sudden Re~e of Pressure
6) PHYSICALSTA~ Solid [ ] Uqu~ ~] G~ [ ] Rure [ ] M~re ~ W~te [ ] ~.[ ]
7) AMOU~ AND~ME'AT FACI~ UNITS OF M~SURE
Average D~ ~oum: . 5 5 curies
~nu~ ~unt:.. .~ 1Q c).Tem~m:
~gest Size'Cont~ner: 5 5
· Da~ on's~e 3~5 Ci~te~ich Months: (All Ye~,)J, F, M, A, M, J, J, A. S, O, N, D
9) MITRE: Ust COMPONE~ C~
the three most h~dous 1) ISOPROPYL ALCOHOL 67-6~-O 40 [ ]
chem~ com~nen~ of
~y AHM com~nents 2) ISOBUTYL ALCOHOL 78-83-1 1-~0
.... · 3) METHYL ALCOHOL 67-56-1 · ~ [ ]
10) Lo~ion BUILDING "C" ' ' ' ' ; .... '-'
2) CommonN~,: W=300 B~'k CLE~ GEL I & II 3) ~T~(o~
Chem~Name~ CELLULOSE ETHER ~M [ I CAS · 9004-62-0
4) PHYslc~ & H~L~ ~HYSlCAL
H~D CA~GORISS ..... Fi~e. [ ] Rea~Ne [ ] - Sudde. Rele~e of ~ressu~e
5) WAS~ C~SSIFICA~'~' ":" (~{g~ Cod~ from OHS Fo~ 8o22) US~ CODE '43
6) PHYS~CALSTA~ So,d (XI Unmd ( I a~ { 1
7) AUOUN~ AND TlU~ A~ FAClU~' UN~m OF U~SURE 8) STO~a~ COO~S
'.""~mO~YAmount: 8000 Ibs~ g~ { ] ~3 [ ~ a~ntdnec 12
Average O~ly Amount: .~ 6000 cune~ :[ ] b) Pressure: 1"
· ,~gest ${z~ ~on~ner: 25
~Oa~OnS~e RR'G" Cirde~ichMonths: (AIIYe~,)J.' F. M, A, M, J, J, ~ S, O, N, O
9) MITRE: Ust coMPoN~ CAS · % ~' ' · ~M
the ~m~ most h~doos ....... 1):-~YD~OXY~E~ CD~g~OS~ ..................... 9004-62-0-. 90'~ =' ' [ ]
chemi~ ~m~nenm or
'RI~ N~~ ~ ~ o~ ~odz~ Com~y Represen~~ ' Sign~-
9usine~ Name BA~R HUGHES INTEQ Add(~':'"55~ST 'ALD~' CT. .
2) ~m~oN.~: ~-322 ~[G~ T~M~U~ ~~ 3) ~T~(o~
C~m~N~e: ~T]T,PAHT~ A~'T~ .~M [ ] C~
4) PH~IC~ & H~ PH~IC~ H~
H~D CA~GORIES Fire [ ] Re~ [' ] Sudde~ Rele~e of Pressure [. ] Im~e He~ ~e) ~] ~ He~ (~mn~) [ ] '
6) PHYSICAI_STA~ Solid ~] Uqu~ [ ] 'G~ [ ] , , . Rum ~] M~re [ ] W~te [ ] ~.[ ]
7) AMOUNT AND ~ME AT FACI~ '" ': "? ' : UNITS OF M~ORE 8) STOOGE CODES
M~mumD~'~unt: ~00' ': "' ~ ~] g~ [ ] ~3 { ]. ~ Con.nec 12
Average DmN Amount: ~Q~ tunes [ ] b) Pressure: · -
Annu~ ~unt: ' 750. c) Tempera:
~gest Size'Cont~ner: ' 50
· Da~ On S~e 3~5 Ci~le ~ich Months: All Ye~, J. F, M. A, M, J, J, A. S, O. N, D
9) MITRE: Ust COMPONE~ CAS · % ~ ~M
the three most h~dous 1) SUnChIC ACTD ~?q~4~ ]O~ [ ]
chem~ com~nen~ or
~y AHM ~m~nents . 2) . · · [ ]
3) []
10) Loc~ion ~[~D[~G "lC" '" ' .'.. '-
1) IN~NTORYSTA~S: New-~'i"~[~'"~' ~e~sio,{ ~ Oeletion( ]- · Check~chemi~isaNON~DES~R~] '~ESECR~ [
2) Common N~e: ~-324 S~C~ ~~ 3) ~T ·
Chemica Name: ~ONIU~ pE~ULPHATE~PEROXyGEN AHM [ ] CAS ·
4) PHYSICAL & H~L~ PHYS~CAt
H~O CA~SORIES Fire. k ] ' Rea~ive~ -]: Sudden Rele~e of Pressure ~ ] [mmedi~, He~ (Ac~e) ~] ~[ayed He~ (Ch~n~) [ ]
5) WASTE C~SSIF[CA~N .... .(~ig~ Cod~'~om DHS Fo~ 8022) USE COOE 4 3
7) AMOUNT ANO ~MEAT FAC[U~' UNITS OF M~SURE 8) STO~5 COO~S
'"'M~imumOailyAmount: 20 lbs,] G~ [ ] ~3 [ ] a) Coot~,e~ 99 ~bPER DRUM
Average Omly Amount: ~ curies [ ] b) Pressure:
. ~gest Size Cont~ner: 30
· Oa~OnS~e 3~5 Circle~ichMonth~: (.~.J.F. M, A, M, J, J, ~ S, O,
9) MITRE: USt COMPONENT CAS · % ~' ~M
the three most h~dous ......... 1)"'A'MM~TT]M ' ~UL~:TE ................ 7?27~54-.0 1on [ ]
chemi~ com~nenm or
ce~ un. er pen~ of ~aw, ~at / have pe~on~/y e~/n~ ~ ~ /~ifi~ w~ ~e in/ore.on sub~ on ~ ~~ d~umen~
CHA~'E'g"~AY~NCE SR. COMPLETIONS SPECIALIST //~~~/~~
PRI~ N~e & Uffe of A~odz~ Comfy Represenm~e Sig~ ~~
~usine~ Name B~R HUGHES INTE~ Aaa~'~<.~:~:~.~l:~~-'~:e~. '"
~ :-' '/'" :'"' ~ " CHEMICAL DESCflI~iON '-'
1) :IN~O~ STA~S: N~:[~:' ~n [ ] Re~n [ ]' ~le~ [ ]' C~'~ c~m~ ~' a NON ~ 8~'
2) ~m~nN~:~-~2[ N~D[~ m~H~. ~~ 3) ~T · (o~
4) PH~IC~ & H~ ' PH~IC~ H~
H~D CA~ORIES ~re [ I Re~ ~ Sudden Re~ of Pressure [- J im~e He~ ~e) ~ ~ He~ (Chron,) [ I '
6) PHYSICALSTA~ ~lid [ ~ ~qu~ [~] G~ [ ] ~ure [ ] M~re ~ W~te [ ]
7) AMOUNT AND'~ME AT FACI~ UNITS OF M~SURE
~mum ~'~um:' 2'20' ~ [ I ~ ~ ~3 [ ] a) ~ne~ '. 07
AvemgeO~N~oum: . ~00 cudes [ ] b) Pressure:
~gest Size'Cont~ner: ~ 5
· D&~ On S~e ~6~ Ci~le~ich Months: (All Ye~.)J. F. M. A. M. J. J. A. S. O. N. D
9) MITRE: Ust COMPONE~ C~ ·
the three most h~dous 1) ~YD~OCE~O~ZC ~CZD 7647-0Z-0 35
chem~'com~nen~ or
~y AHM com~nents 2). [ ]
.... . .~). []
10)' Loc~ion ~Z~DZ~G "C ..... :: '
~ ~o -.~ :: -=~..,. ·
............... C EU CF .DESCR O"
~...
1) IN~NTORY STA~S: New~"~i~ ~'~] Re,sion [ ] ~letion [ ] Che~ ff chemi~ ~ e NON ~OE S~R~ [~ '~E SECR~ [ ]
2) Co.mm.on ~: ~-350 BZG~ -~H~. G~ S~Z~Z~ 3) ~T · (o~
Chemi~ H~e: ~Z~/G~YeO~ HZX~U~ AHM [ ] CAS
4) PHYSICAL & H~L~ PHYSICAL H~
H~D CA~GORIES .... Fire. [ } .. Re~m~e [ ] - Sudden Rele~e of Pressure [ ] Immedi~e He~ (Acme) ~Z ~layed He~ (Chron,) [ ]
5) WASTE C~SSIFICA~' ":" .(~ig~ Cod~'~om OHS Fo~ 8022) USE CODE "~ 3
6) PHYSICALSTA~ Solid [ ] Uquid [~ G~ [ ] Pure [ ] Minute ~Z W~te [ ) RedioemNe [ ]
7) AMOUNT AND TIME ~T FACI~' UNITS OF M~SURE 8) STOOGE CODES
'.""M~imbm Oaily Amount: 55 lbs [ ] g~ ~ fi3 [ ] a) ~nt~nec 06
Average Omly Amount: .~ 55 cu~es [ ] b) Pressure: ]4",
....... Annu~'~0unt:-'2':L:':L' 55 ......... "' ' ' c)-Tem~re: '
,~gest S~ze Cont~ner: R R
~o,~o,.s~, ~ Ci~=~,~i=h Mo,th~: (A, Ye~ d. F.' M. A. M. ~. d. ~ S. O.
9) MITRE: Ust COM~ONE~ CAS · %
the~memost.h~dous ...... 1)-':~Z'N'E/~LYeOL MIX-~ .................... · ....... N/E . 100: '[ ]
chemi~ ~m~nenm or
~y~M ~m~nts~2:::--~22):ctL-:::::.:::':::::~:.-:..~_:---.~ .-:.-. -: ........ .-.. ...... . : ... .................... [ ]
)Ri~ N~e & ~Ee of ~odz~ Co~y Represen~e ~~ ~ ~
llrL 6117 schirra Court Bakersfield, CA 93313 L~
805-834-9654 Fax: 805-834-2450 i~'E~ g ? 1996
By
City of Bakersfield 22 Feb 96
1501 Truxton Ave
Bakersfield, Calif'93301-0000
RE: HAZ MA T FEES
Sir or Madame:
I am enclosing the following:
1) Copy of our paid HAZMAT fees for the 6117 Schirra Ct facility (customer # 3053),
2) The originalinvioce for BAKER OIL TOOLS located at the address 4.~3_~stomer #3951). ~-~--'-'
~o~: ~ouo~ ~o~ co~.~s ~w ~.~ ~o~s ^s ^ P~ co~,r~,
THEY BOTH OPERATE AS SEPARATE ENTITIES AND SHOULD BE BILLED AS SUCH. BAKER
OIL TOOLS HAS THEIR OWN SHOP AND OFFICE AT THE FOSTER ADDRESS. THEIR HAZMAT
FEES ARE FOR T/-IEM TO PAY. CONTACT CRAIG WHITTLER, MGR OF BAKER OIL TOOLS
FOR INFO.
Regional ~SF. Coordinator
cc: Jim Van Hoozen BAK BHI
Becky Silva BAK BI-l/
STATEMENT OF ACCOUNT
~C~{V~D CIT~ OF BAKERSFIELD
15Ol TRUXTUN AVE
4AN 1 1%~6 BAKERSFIELD, CA 93301-0000
BAKERSFIEI..O
(805) 326-3979
DATE: 1/01/96
TO: BAKER HUGHES INTEQ
6117 SCHIRRA CT
BAKERSFIELD, CA 93313
CUSTOMER NO: 3053 CUSTOMER TYPE: ES/ 3053
CHARGE DATE DESCRIPTION REF-NU~BER DUE DATE TOTAL AMOUNT
12/01/95 BEGINNING BALANCE V£N~0, N0. /~-' ,- ,,.%~)[.~ ,00
HM009 1/01/96 HAZ MAT HANDLING FEE I -, 158.00
HM017 1/01/96 HAZ ~T AN~AL INSPECTION~v0;~SN0.. ~_~ ~ ~ 50.00
INVOICE DATE m~ ' - ~ ' ~ / ~ m ,
DOCUMENT NO .....
DIST. CODE ~(~ ~1,~ . ~ ~~
8~L L BACK T0 CU~. ~S ~ ~e~u
Please call 326-3979 if you hav= estion or
changes regarding your account,
CURRENT OVER 30 OVER 60 OVER 90
208.00
DUE DATE: 1/01/96 PAYMENT DuE: 208.00
TOTAL DUE: $208.00
...... ' ....... I REMITTANCE;,,
'. ~, '., ~' i~:-:PLEASE DETACH AND: SEND -THIS -COPY 'W TH
REMIT AND ~KE ,CHECK PAYABLE TO: ~-. - ..~. ,-
CITY OF. BAKERSFIELD ~ , ',.
P.O. BOX 2057~:' ~ .
BAKERSFIELD CA 93303-2057
CUSTOMER NO: 3053 CUSTOMER TYPE: ES/ 3053
TOTAL DUE: $208.00
STATEMENT OF ACCOUNT
CITY OF BAKERSFIELD
1501 TRUXTUN AVE
BAKERSFIELD, CA 93301-0000
(805) 32 -3979
~ ~ AVENUE
BAKERSFIELD, CA 93308-4559
CUSTOMER NO: 3951 CUSTOMER TYPE: ES/ 3951
--C'H~RG'E- -- D~TE- DESC~I P~I O'N- -- - R~F~ NU~BER-DUE--DDfI2E~TOT~'L---~M~U'N~ ....
12/01/95 BEGINNING BALANCE .00
HM016 1/01/96 HAZ MAT HANDLING FEE P 422.00
HM017 1/01/96 HAZ MAT ANNUAL INSPECTION 50.00
Please call 326-3979 if you have question or
changes regarding your account.
CURRENT OVER 30 OVER 60 OVER 90
472.00
DUE D~T~:--!-/~9-~-
TOTAL DUE: $472.00
T PLEASE DETACH AND SEND THIS COPY WITH REMITTANCE
1/01/96 DUE DATE: 1/01/96
AND MAKE CHECK PAYABLE TO:
CITY OF BAKERSFIELD
P.O. BOX 2057
BAKERSFIELD CA 93303-2057
CUSTOMER NO: 3951 CUSTOMER TYPE: ES/ 3951
TOTAL DUE: $472.00
BAKER. IELD CITY FIRE DEP i :ITMENT
t~/° '> ...... ,_ --~ 'H~DOUS MATERIALS INVEI~TORY ~age / of~
CHEMICAL DESCRI~ION ~
.
) INVENTORY STA~S: New'~..'Addition [ ] Revision [ ] ~letion [ ] Check ~chemi~ is a NON ~DE SECR~ ~DE SECR~ [ ]
2) co~mo. N~: ~Z~~ / ~ Z 3) ~T. (op~o.~)
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~D CA. GOal,S Fire [ ] ~eacfive [ ] Sudden ~ele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~. ~layed He~h (Chronic) [ ~
S) WASTE C~SSIFICA~ON ~ / (3-digit code from DHS Fo~ ~022) USE CODE
6) PHYSlCALSTA~ Solid [ ] Liquid ~ G~ [ ] Pure [ ] M~um ~ W~te
7) AMOUNT AND ~ME AT FAClLI~ UNITS OF B~SU~E a) STOOGE CODES
M~imum D~iy Amount: /~ O ~ [ ] g~ ~ fi3 [ ] a) Contaner:
Average D~ly Amount: ~ curies [ ] b) Pressure: /
Annu~ Amount: ~ c) Tem~r=ure:
~gest Size'Container:
~ Days On Site _~ Circle ~ich Months: ~ J, F, M. A, M, J, J, A, S. O, N. D
9) MITRE: ~st COMPONENT % ~ ~M
chemic~ components or
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New ~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemiC, is a NON ~DE SECR~
2) Common N~e: ~ ~ ~, ~/. ~ ~ ~ 3) ~m · (option~)
Ch.~i~N~me: ~C~ ~-- ~ ~WA~ AHM[ ] CAS~
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ~ Reactive [ ~ Sudden Rete~e of Pressure [ ] Immedi~e He~h (Ac~e)
5) WASTE C~SSIFICATION ~ / (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid,~ Liquid [ ] G~ [ ] Pure ~ Mi~ure [ ] W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~eO0 ihs ~ g~ [ ] fi3 [ ]
Average Daily Amount: ~ ~0 curies [ ] b) Pressure: /
Annu~ Amount: ~ c) Temper~ure:
~gest Size Container: ~ ...
· a.y.o.s~. ~ Ci~.~hMon~h~: ~J. F, M, A, M,
9) MITRE: Ust COMPONENT CAS · % ~ ~M
chemi~ com~nen~ or
3)
~o) ~o~,on ~~ ~
ce~ under pen~ of law, ~at I have pemonatly examin~ ~d am f~ili~ wi~ ~e infomafion submi~ on ~is ~d
submi~info~aEonis~e, accurate,~dcomplete.
~INT Name& Title of Au~orized Company Represenm~ve / ' Dam '
, , BAKER, ELD CITY FIRE DEP ITMENT
HAZ FIDOUS MATERIALS INVEN'rORY PagoZ. of,~Z--
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check ff.chemi~ is a NON ~DE SECR~ [~ ~DE SECR~
4) PHYSICAL & H~L~ PHYSICAL H~L~,_
H~RD
CA~GORIES
Fire
[
}
Reactive [ -i Sudden Rele~e of Pressure [ ] ImmediMe He~h (Ac~e) ~ ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~/ (3-digit code from DHS Fo~ 8022) USE CODE / /
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~Ne
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE B) STOOGE CODES
M~imum D~Iy Amount: ~000 I~ ~ g~ [ ] ~3 [ ] a) Contaner:
Average Daily Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: ~ ~ c) Tem~r~ure:
~gest Size'Container: , ~0
~ Days On Site ~ Circle~ich Months: ~J, F, M, A, M, J, J, A, S, O, N, D
9) MITRE: Ust ~ L~ COMPONENT CAS~ %~ AHM
the three most h~ardous 1) ~ ~ ~/0~ ~ ~C~ ~ ~0~ --~-~ /00 [ ]
chemic~ componen~ or
any AHM com~nen~ 2) [
3) [
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New {~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~ ~ ~DE SECR~
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~} ~layed He~h (Chron.)
5) WASTE C~SSIFICA~ON ~ ~/ .(3-digit code kom DHS Form S022) USE CODE
6) PHYSICALSTA~ Solid ~ Liquid [ ~ G~ [ ] Pure ~ Minute [ ] W~te [ ] Radioa~ive [
7) AMOUNT AND TIME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
/
Average Dmly Amount: ~0 cudes [ ] b) Pressure:
Annu~ Amount: ~ ~ 0 c) Temper~ure:
~gest Size Container: ~0 ,
· Days On Site ~ Circle~ich Months: NIYe~, J, F, M, A, M, J, J, A. S,,'O':~ N. D
9) MITRE: ~st COMPONENT CAS ~ % ~ ~M
chemi~ com~nen~ or
~y AHM com~nents '2)
3) [
of A~orized Company ~epresen~ve Signa~re ~ Dam
, , BAKERS/ ELD CITY FIRE DEP,/ ITMENT
HAZ [I DoUS MATERIALS INVENTORY Page,~W of.]Z
CHEMICAL DESCRI~ION
1) IN~ORY STA~S: New~ Addition [ ] Revision [ ] ~letion [ ] Check, chemi~ is a NON ~DE SECR~
~DE
SECR~
4) PHYSICAL & H~L~ PHYStCAL H~L~
H~RD CA~GORIES Fire [ [ Reactive { ] Sudden Relate of Pressure [ ] ImmediMe He~h (Acme) ~ ~layed He~h (Chronic)
5) WASTE C~SSIFICA~ON ~/ (3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICALSTA~ Solid ~] Uquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~e [
7) AMOUNT AND ~ME AT FACILI~ UNITS OF M~SURE 8) STOOGE CODES
M~imum DaJyAmount: /~ I~ ~ g~ [ ] ~3 [ ] a) Cont~ner:
Average Omly Amount: /~e curies [ ] b) Pressure:
Annu~ Amount: / ~e c) Tem~r~ure:
~gest Size'Container:
~DaysOn Site ~G~~ Circle~ich Months: ~, F, M, A, M, J, J, A, S, O, N, D
9) MITRE: Ust COMPONENT % ~ AHM
the three most h~dous 1) ~ ~ ~~ ~ ~ ~ ~ ~ ~~0-
chemig~ componenm or ..
any AHM com~nents 2) [
3) [
CHEMICAL DESCRI~ION
1) INVENTORY,STA~S: New~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~
Chemic~ Name: ~Z~ C/C ~IC ~ AHM [ ] CAS ·
4) PHYSICAL & H~L~ PHYSICAL H~L~__
H~RD CATEGORIES Fire [ ~ Reactive [ J Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron,) [ ]
5) WASTE C~SSIFICATION ~/ (3-digit code kom DHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid ~] Liquid [ ] G~ [ ] Pure [ ] Minute ~ W~te [ ] Radioamive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~ ~0 lbs ~ g~ [ ] fi3 [ ] a) Contaner:
Average Daily Amount: / ~/~ cudes [ ] b) Pressure:
Annu~ Amount: ~ ~ ~ c) Temper~ure:
~gest Size Container: ~ ~ .....
M/
~ Days On Site Circle~ich Months: ~ J.F.A.M.J.J.A.
N.
D
9) MITRE: ~st COMPONEN~ CAS · % ~ ~M
chemi~ com~nen~ or
ce~'~ under Pen~ of law, ~at I have pemonafly examin~ ~d am f~ili~ wi~ ~e infoma~on submi~ on ~is ~d ~1 a~ch~ documenm.
submi~ info.ab'on is ~e, accurate, ~d complote. / ~~ ~ ~ ~
PRINT Name & ¢iCe of A~orized Compan~ ~epresen~O've Da~
, , BAKER., i IELD CITY FIRE DEPt i TMENT
H/ ' DOUS MATERIALS INVEI TORY
Page_~of
Business Name ~~,., ~ff~ /~Address ~/ ~Z~,~ ~ ~/~¢~ ~ ~ ·
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check ff chemi~ is a NON ~DE SECR~ ~ ~DE SECR~
2) Common N~e: ~Z Ct ~ ~ e ~R~ 3) ~m · (option~).
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acute) ~ ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~/ (3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~e [ ]
7) AMOUNT AND ~ME AT FACILIW UNITS OF M~SURE e) STOOGE CODES
U~imumD~tyAmount: ~OOO I~ ~ g~ [ ] fi3 [ ] a) Cont~ner:
/
Average D~ Amount: /'~ curies [ ] b) Pressure:
Annu~ Amount: ~eo c) Tem~r~ure:
~gest Size'Container:
~ Days On Site ~ Circle~ich Months: ~ J, F, M, A, M, J, J, A, S, O, N, D
9) MITRE: Dst COMPONENT CAS · % ~ AHM
the three most h~dous 1) ~ ~/~ ~ ~~~ /~/ 2-- ~
chemig~componen~Orany AHM com~nents 2) ~ [/~ / ~r/~CZ,~¢ ¢~4~Z /V¢O~-~O'~ 3 [ ]
3) [
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New [~ Addition [ ] Revision [ ] Deletion [ ] Check E chemi~ is a NON ~DE SECR~
Chemica Name: ~ 6¢t~m ~O0~ AHM [ ] CASe
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Rele~eof Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.)
5) WASTE C~SSIFICA~ON ~/ .(3-digit code from DHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ MinuTe [ ] W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: /ZOO 0 lbs ~ g~ [ ] ~3 [ ] a) Contmner:
Average D~ly Amount: ~¢¢ curies [ ] b) Pressure:
Annu~ Amount: / ~_OOO c) Temper~ure:
~ges[ Size Container:
9) MITRE: Dst COMPONENT CAS · % ~ ~M
chemi~ com~nen~ or
3) [
~o) Lo~o. ~~ ~~ C
PRINT Name &~iSe of A~orized Company RepresenTS'ye Si~a~re / Da~
, . BAKERSi IELD CITY FIRE DEP, :ITMENT
D OUS MATER IALS I NVEI I'ORY Page_ T'of 2_._z
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New/~ Addition [ ] Revision [ ] Deletion [ ] Check if chemicat is a NON TRADE SECRET~ TRADE SECRET [ ]
2) Common Name: ~_----'~ ~.-~_..-//.4--~1,~ ~..'~g~/~7~"' ~0'0 - ZO ...~,..) 3) DOT # (optional)
ChemicalName: ~:~ ~-~-- ~ ~(Z.~**'.J/e~1~' AHM [ ] CAS#
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive I i Sudden Release of Pressure [ ] Immediate HeaJth (Acute) ~ Delayed Health (Chronic) { ]
5) WASTE CLASSIFICATION ,,.~2.,~ ,(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ~ Liquid [ ] Gas ( ] Pure [~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: y~O 0 lbs ~'~ gal [ ] ft3 [ ] a) Container:
Average Daily Amount: ~) , curies [ ] b) Pressure:
Annual Amount: ,~-.ZO ~ · c) Temperature:
Largest Size'Container:
# Days On Site ~0'" Circle Which Months: ~, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List COMPONENT CAS #
the three most hazardous 1) C/~ ~---/ ~t'/'l,'/ ~/~/~'~#~u/,''~'/''~''~' /~,v~' ~J~-~' ~__~_. AHM[]
chemical components or
anyAhM components 2) ~'/~/~ // ¢~'?~(J"~.~./~/~"f' t~/..~/~/"~ /'~/o°~Z-6o-2 "~ []
3). [ ]
Location
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New-,~'~ Addition [ j Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET [~ TRADE SECRET [ ]
2) Common Name: ~4~t~"," C~ ,~ 3) DOT # (optional)
Chemical Name: ,,,~.-_~ ~/U ~P~. ?~ O/'~oX / ~)~" AHM[] CAS#
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Reieaseof Pressure [ ] Immediate Health (Acute) ~] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION ,,~"/ .(3-digit code from DHS Form 8022) USE CODE //
6) PHYSICAL STATE Solid [/~ Liquid [ ] Gas [ ] Pure.~ Mixture [ ] Waste [ ] Radioactive [
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~'~0 IDs ~ gal [ ] ft3 [ ] a) Contaner: / ~.-,
Average Daily Amount: ..~_.~oe cudes [ ] b) Pressure:
Annual Amount: .~i~_~ ~'~ c) Temperature:
Largest Size Container: .c~-O ,..
# Days On Site ,.~"' Circle Which Months: All Year, J, F, M, A, M, J, J, A, S,..O~ N, D
9) MIXTURE: tist COMPONENT CAS # % WT AHM
chemic.~ components or
any AHM components '2). [ ]
3) [ ]
PRINT Name ~[ Title of Authorized Company Representative
, , BAKER ii ELD CITY FIRE DEP, TMENT
H DOUS MATERIALS INVEN"I'ORY Page of__ 2--"
BusinessName.~/~ ~?~~-~Address ~ ~~J ~ ~~~
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition { ] Revision [ ] ~letion { ] Check ~chemi~ is a NON ~DE SECR~
2) Common .~e: ~~~ ~ ~ 3) ~T ~ {op6on~)
Chemi~N~e: ~~ ~ AHM[ ] CAS~ ~'~ ,
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ I Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic) [ ]
5) WAS~ C~SSIFICA~ON ~/ (3-digR code kom DHS Fo~ 8022} USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~e [ ]
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~Iy Amount: /~ I~ ~ g~ [ ] fi3 [ ] a) Contaner:
Average Dmly Amount: ~ curies[) b) Pressure:
Annu~ Amount: c) Tem~r~ure:
~gest Size'Container:
~ DaysOnSite Z{~ Circle~ich Months: ~J, F, M, A, M, J, J, A, S, O, N, D
9) MITRE: ~st COMPONENT CAS ~ % ~ AHM
the three most h~ardous 1) {
chemJ~ componen~ or
any AHM com~nents 2) [ ]
3) [
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New~ Addition [ ] Revision [ ] Deletion [ ] Check ~chemi~ is a NON ~OE SECR~ [
2) Common N~e: C ~ ~C~ 3) ~T * (option~)
4) PHYSICAL.& H~L~ PHYSICAL H~L~,~
H~RD
CA~GORIES
Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acme) ~ ~layed He~h (Chron.) [ ]
5) WASTE C~SSIFICA~ON ~/ (~digit code from OHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure [ ']' Minute ~ W~te [ ] Radioamive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
U~imum Daily Amount: /~OO lbs ~] g~ [ ] ~3 [ ] a) Contaner:
Average D~ly Amount: ~ ~ cudes [ ] b) Pressure:
Annu~ Amount: ~ o OD o c) Temper~ure:
~gest Size Container: ~ G~ ~, .' . ..
· Days On Site ~ Circle~ich Months: F, M, A, M, J, J, A,
9) MITRE: Ust ~ COMPONENT CAS · % ~ ~M
the three most h~dous 1) ~ ~1 ~ ~ ~ ~ .j
chemi~ com~nen~ or
10) Lo.ion ~~~ ~-
~e infoma~on su ' '~ on ~is ~d ~1 a~ch~ documen~ I believe
submi~ info~affon is ~e, accurate, ~d complete. .
PRINT Name ~le of A~orized Company Represenm~'ve Signature (
, BAKER.?ii IELD CITY FIRE DEP ClTMENT
H/ J DOUS MATERIALS INVEhrTORY
Pagez of
BusinessName,~-Z/~}~'-/~ ~y~ /~--¢ Address ~/ ~~)~ ~ ~~~ ~~-
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New~ Addition [ ] Revision [ ] ~lefion [ ] Check ff chemi~ is a NON ~DE SECR~ ~ ~E SECR~ [ ]
2) Common N~e: ~ ~F ~ ~ ~ 3) ~T · (opaon~).
Chemi~ N~e: ~/~ ~ ~/~/~ ~~ ~ AHM [ ] CAS ~
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive~ ] Sudden Rele~eof Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic) [
5) WASTE C~SSIFICA~ON ~ (3-digit code ~om DHS Fo~ ~022) USE CODE
6) PHYSICAL STA~ Solid ~ ~quid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ]
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
/
O
o
O
M~imum
D~lyAmount: lbs ~ g~ [ ] fi3 [ ] a) Contmner:
Average Dmly Amount: ~O ~ 6 curies [ ] b) Pressure:
Annual Amount: ~ ~ ~ e c) Tem~r~ure: ,
~gest Size'Cont~ner:
· Days On Site ~ Circle ~ich Months: ~Ye~, F, M, A, M, J, J, A, S, O, N. D
9) MITRE: ~st COMPONENT CAS ~ % ~ AHM
the three most h~ardous 1 ) [
chemic~ componen[s or
any AHM com~nents 2) [ ]
3) [ ]
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New ~ Addition [ ] Revision [ ] Deletion [ ] Check E chemi~ is a NON ~DE SECR~ ~ ~DE SECR~ [ ]
2) Common N~e: ~ ~ ~ ~ 3) ~T · (option~).
Chemic~ Name: ~/ C ~n~ O~ ~~C ~~ ~M [ ] CAS ·
4) PHYSICAL & H~L~ PHYSICAL H~L~.~
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Rele~eof Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.) [ ]
5) WASTE C~SSIFICA~ON ~ ~/ (~digit code kom DHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure [ ] Minute ~ W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TiME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~ ~ lbs ~ g~ [ ] ~3 [ ] a) Contaner:
Average D~ly Amount: ~ cunes[ ] b) Pressure:
Annu~ Amount: ~ ~ ~ e c) Tem~r~ure:
~gest Size Container: ~ ~ ' ... '
· DaysOnSite ~ Circle~ich Months: ~IY~J, F. M,'A, M, J, J, A, S,,,~:' ~, D
9) MITRE: Ust ~ COMPONENT CAS · % ~ ~M
the three most h~dous 1) ~/~ )~ ~l~ /~/0. ~
chemi~ com~nen~ or
ce~'~ under pen~ of law, ~at l have pemonally examin~ ~d am f~ili~ wi~ ~e infoma~on ~E~ on ~i, ~d ~1 .~:h~ document.
submi~, inf o~a~on is ~e, a c c u~ te, ~d complete. ~~A
P~INT Name & ~tle of A~orized Compan~ Bepresen~'ve Si~na~re ~
BAKERS/i ELD CITY FIRE DEP/ ITMENT
H DOUS MATERIALS INVEN'PORY Page ofZ-z---
Business Name ~.~/~¢¢Z~'/~, ~ ~, ,/~ ~ Address ~/ ~~ ~ ~ ~/~~ CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New~ Addition [ ] Revision [ ] ~letion [ I Check Echemi~ is ~ NON ~DE SECR~ ~ ~DE SECR~ [ ]
2) Common N~e: ~ ~ 0 0 3) ~T ¢
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedime He~h (Acute)
5) WAS~ C~SS~F~CA~ON ~/ ,(3-aigit cod~ ~o~ DHS Fo~ S02~) USE COOL
6) PHYSICAL STA~ Solid [ ] Liquid~ G~ { ] Pure [ ] M~ure~ W~te [ ] R~ioa~e [
7) AMOUNT AND ~ME AT FACI~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~lyAmount: //~O I~ [ ] g~ ~ fi3 { ] a) Contaner:
Average D~N Amount: //~ curies [ ] b) Pressure:
Annu~ Amount: //~ c) Tem~r~ure:
L~gest Size'Container: ~ .'
~ Days On Site ~ Circle~ich Months~~J, F, M, A, M, J. J, A. S, O, N. D
9) MITRE: ~st ~ COMPONENT CAS ~ % ~ AHM
the three most h~dous 1) ~ ~~OJ ~O ~ ~-~'/ /O-~O. [ ]
chemic~ components or
any AHM com~nenm 2) [ ]
3). [ ]
lO)
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New ~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is s NON ~DE SECR~ ~ ~DE SECR~ [ ]
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire { ] Reactive [' J Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.) [ ]
5) WAS~ C~SSiFICA~ON ~/ (~digit code ~om DHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid [ ] Liquid ~ G~ [ ] Pure [ ] Minute ~ W~ta [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACID~ ~ O UNITS OF M~SURE 8) STOOGE CODES
M~imum O~ily Amount: lbs { ] g~ ~ ~3 [ ] a) Contaner:
Average D~ly Amount: ~ ~, cu~es [ ] b) Pressure:
Annu~ Amount: ~ ~ c) Tem~r~ure:
~gest Size Container: ~ .' ...
* Days On Site ~ Circle ~ich Months: ~ J, F. M, A. M, J, J, A, S.,'8<:' N, D
9) MITRE: Mst ~ CDMPONENT CAS
the three most h~dous 1) ~ ~ ~e~ ~Z~~ 2~' ~'--~
~M
chemi~ com~nen~ or
~y AHM com~nen~ '2) [
[
ce~ under pen~ of law, ~at / ~ave p~monatly examm~ ~d am f~ili~ wi~ ~e infome~on su~i~ on ~is ~d ~1 a~ch~ document. I believe
submi~info~a~onis~e, accumte,~dcomplete.
PRINT Name & Title of A~orized Company Represen~five ¢ ~ Signa~re,~__ Da~
BAKER,? i IELD CITY FIRE DEP i :ITMENT
HAZ3A'RDOUS MATERIALS INVENTORY
Page/4)of
Business Name ~//~-f~, /~J~4 ¢~'~c~'~'J'.,/,/~. ,/~'--~-~Address ~,,/~'/ A~.0¢~,,J ~ ~'~'/~'~ CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New Addition [ ] Revision [ ] Deletion { ] Check if chemical is a NON TRADE SECRET TRADE SECRET
2) Common Name: ~,~,,~,//~" -- Z ,~d..,,~ ,3) DOT # (optioneJ)
ChemicalName: ~'~l ~/'~L.~") e,,,.) ~,~'~/.. ,/'~.,.q-'~/'~ AHa[ ] CAS#
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ i Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health
(Chronic)
5) WASTE CLASSIFICATION ,.~",/ (3-digit code fi'om OHS Form 8022) USE CODE //
6) PHYSICAL STATE Solid ~ Liquid [ ] Gas [ ] Pure [~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: /~/'~OO lbs J)~ gal [ ] ~t3 [ ] a) Container:
Average Dali./Amount: ~'~/~'e curies [ ] b) Pressure: ,!
Annual Amount: ~O ~ ~ c) Temperature:
Largest Size'Container:
# Days On Site ~ ~,.T" Circle Which Months: ~ J, F, M, A, M, J, J, A. S, O, N, D
9) MIXTURE: USt Z/ COMPONENT CAS # ~,~V~ AHM
the three most hazardous 1) ~-'~,v',~/~/~"~ ~ /~r' ~---~'~. ~&f Jd~' /~/'/J"-c~'~,t~-~' []
chemiCal components or
3) [ )
lO) Lock,on (..C/ ,d ,Z~"~,.,.rE
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [~ Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET .~. TRADE SECRET
2) Common Name: //~/0.~'/.~/(7 ~/~'"~ 3) DOT # (optionaJ)
Chemical Name: Z~::~ ~" ~../~.~.,/~/"~O~,.) ~_~,,~/~2.0/..- AHM [ ] CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH. o
HAZARD CATEGORIES Fire [ I Reactive [ 1. Sudden Release of Pressure [ ] Immediate HeaJth (Acute) ~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION ~k-'2// (3-digit code fi'om OHS Form 8022) USE CODE
6) PHYSICAL STATE Solid j~ Liquid [ ] Gas [ ] Pure ~ Mixture { ] Waste [ ] Radioactive [ }
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
/j
P'p'o
M.x~mum De,y Amount: ~s D(f gal [ ] .3 [ ] a)
Container;
Average Daily Amount: ~.~..~ ~'~ cudes [ } b) Pressure:
Annual Amount: ~.~, ~ · c) Temperature:
Largest Size Container: ~ O ..
# Days On Site ~, ~ Circle Which Months: All Yem', J, F, M, A, M, J, J, A, S,,'~;' Ni D
9) MIXTURE: List COMPONENT CAS # % WT AHM
the three most hazardous 1 ) [
chemical components or
any AHM components '2) [ }
3) [
PRINT Name'.~Title of Authorized Company Repres"entatiV e Signature / Date
BAKER. i IELD CITY FIRE DEP i ITMENT
H DOUS MATERIALS INVER'rORY
Page//of
Business Name _ , //7/-~.~'~/~-'~ ,/~J~7~ Address <~'~'"~-'/ ~)~)f[/,~ ~ ~/~~
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New~ Addition [ ] Revision [ ] ~letion [ ] Check ~chemi~ is a NON ~DE SECR~ ¢ ~DE SECR~ [ ]
2) CommonN~e: ~ Z C~ -- ~, C ~/~ ~/~-~ C~ 3) ~T · (opting).
Chemi~ N~e: ~Oj~ ~/~ ~ e~ ~/~{ AHM[] CAS*
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ [ Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acme) ~ ~lsyed He~h
(Chronic)
s) WAS~ C~SS~F~CA~ON ~/ (3-digi~ come ~om DHS Fo~ S022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid { ] G~ { ] Pure~ M~ure [ ] W~te [ ] R~ioa~Ne [
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~iyAmount: ~0 lbs~ g~ [ ] ~3 [ ] a) Con. neE
Average D~ Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: ~ ~ c) Tem~r~ure:
~gest Size'Cont~ner:
~ Days On Site ~ Circle ~ich Months: All Ye~, J, F, M, A, M. J, J, A, S, O, N.
9) MITRE: Ust COMPONENT CAS ~ % ~ AHM
the three most h~ardous 1) ~/~ ~0/-~-~ /Od [ ]
chemic~componentSOranyAHMcom~nen~ 2) ~4/*~ / -C~~/~E ~r~ /¢gCg- dO--~ 4 ~ [ ]
3) [
1) INVENTORY STA~S: New [~ Addition [ ] Revision [ ] Deletion [ ] Check Echemi~ is a NON ~DE SECR~ ~ ~DE SECR~ [ ]
2) Common N~e: ~ ~ 3) ~m · (option~)
Chemic~ Name: ~~ ~ ~ ~ AHM [ ] CAS ¢
4) PHYSICAL & H~L~ PHYSICAL H~L~__
H~RD CATEGORIES Fire [ ] Reactive.[ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.) [
5) WASTE C~SSIFICA~ON ~/ (~digit code kom DHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ Minute [ ] W~te [ ] Radioa~ive [
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
g~ [ ] ~3 [ ] a) Cont~ner:
Average D~ly Amount: ~ 0 b) Pressure:
Annu~ Amount: ~¢~ ~ c) Tem~r~ure:
~gest Size Container: ~ .' . .. ;
¢ DaysOn Site ~ Circle~ich Months: AIIYe~, J, F, M, A. M. J, J, A, S.:O~'
9) MITRE: Ust COMPONENT CAS · ~ ~M
the three most h~dous 1) ~/~ ~ ~ ~~ 2 ~ ~ ~ ' ~--
chemi~ com~nen~ or
ce~ under pen~ of law, ~at I have pemonally exam~ ~d am f~ili~ w~ ~e infomafion submi~ on ~is ~d WI a~ch~ document. I believe ~e
~RINT Nam~ Title of A~orized Company Represenm~'ve Signa~re / ' Da~
BAKER,?i/ IELD CITY FIRE DEP :ITMENT
H DOUS MATERIALS INVEN"rORY
Page/Lof
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S; New ~ Addition [ ] Revision [ ] ~letion [ [ Check ff chemi~ is e NON ~DE SECR~ ~ ~DE SECR~
Chemic~ N~e: ~ ~ ~ ~ AHM [ ] CAS ¢ ~ ~
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ ] Sudden Rele~e 0f Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~/ (3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~e [
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imumD~lyAmount: /~ ~¢~ I~] ge [ ] ~3 [ ] a) Contaner:
Average D~ Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: ~¢0 c) Tem~r~ure:
~gest Size'Container:
¢ Days On Site ~ Circle~ich Months: ~, J, F, M, A, M, J. J, A, S, O, N. D
9) MITRE: Mst COMPONENT CAS ¢ % ~ AHM
the three most h~dous 1) ~~ ~~ ~o0~
chemic~ componenm or
any AHM com~nen~ 2) [
3) [
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New [~ Addition [ ] Revision [ ] Deletion [ ] Check ~chemi~ is a NON ~DE SECR~
~DE
SECR~
2) Common N~e: ~/~ ~ 3) ~T ·
4) PHYSICAL & H~L~ PHYSICAL H~L~.,
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.)
5) WASTE C~SSIFICA~ON ~ ~'/ (~digit code from DHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid [ ] Liquid ~] G~ [ ] Pure [ ] Mi~ure ~ W~te [ ] Radioa¢ive [ ]
7) AMOUNT AND TIME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~ lbs [ ] g~ ~] ~3 [ ] a) Cont~ner:
Average Daly Amount: ~// cunes[ ] b) Pressure:
Annu~ Amount: _~ c) Temper~ure:
~gest Size Container:
¢ DaysOn Site ~ Circle~ich Months: , J, F, M, A. M, J, J, A, S,,'~;' N, D
9) MITRE: Us, COMPONENT~/~CC W~ ~ ~) ~CAS-~K
chemi~ com~nen~ or
~y AHM com~nenm '2) [
3) [
ce~ undor pon~ of law, ~at l have pe~onatly examln~ ~d am f~iJi~ w~ ~e info~a~on ~ on ~is ~d ~l a~ch~ documen~, l believe ~,
PRINT Name ~ T/fie of A~orized Company Represenm~ve ~ S~a~r~ / Dam
BAKER,?ii IELD CITY FIRE DEP ITMENT
HAZ"A'RDOUS MATERIALS INVEN'rOR
IY Page/3 of zz.,
CHEMICAL DESCRIPTION
1) INV~NTORYSTATUS: New. Addition[ ] Revision[ ] Deletion[ ] Check if chemical is a NON TRADE SECRET [~ TRADE SECRET [ ]
2) Common Name: ~' ! ~ ¢-~ 3) DOT Ct (optional)
CheraCol'Name: /'/y AHMI] CAS,, -- O
/
4) PHYSICAL & HEALTH PHYSICAL HFS. JrTH
HAZARD CATEGORIES Fire [ ] Reactive [' I Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) [
5) WASTE CLASSIFICATION ,~--"/ (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid Liquid [ ] Gas [ ] Pure ~ Mixture [ [ Waste [ ] Radioactive [
7) AMOUNT AND TIME AT FACIUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ,.~'OO O lbs [~ gal [ ] f~3 [ ] a) Container:
Average Daily Amount: /.~'"o ~ curies [ ] b) Pressure:
Annual Amount: ~ c) Temperature:
Largest Size'Container: '
# Days On Site ~.~=~,'~' Circle Which Months: '~")J, F, M, A, M, J, J, A, S, O, N, D
the three most hazardous 1) (~,~.~4.~ COMPONENT AHM
chemicaJ componen[s or
any AHM components 2) [ ]
3) [
10) Location ~/~/¢..~/~¢,¢,~d"C¢'
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New~.J Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET
Chemical Name: ~ ~./~, ~4~./,/~/,~(;.. (~"~-~.~ ZO~'~ AHM [ ] CAS #
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) J~ Delayed HeaJth (Chronic) [ ]
5) WASTE CLASSIFICATION ~'-~'~ .(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ,~ Liquid [ ] Gas [ ] Pure J~ Mixture [ ] Waste [ ] Radioactive [
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
gaJ [ ] ft3 [ ] a) Container: ~'/~.,~ .
Maximum Daily Amount: ~'~0 0 ~;~ lbs J'~cunas [ ] b) Pressure:
Average Daily Amount: ~,~O O
Annual Amount: c) Temperature:
Largest Size Container: ~ · . .. '; - -:
# Days On Site ,~ ~'41'"" Circle Which Months: ~ J, F, M,' A, M, J, J, A, S,,~(~<i' Ni D
9) MIXTURE: List COMPONENT CAS # ~ AHM
the three most hazeYdous 1) ~t'~.~' L~_~. ¢0 0 ~9"~/"~-- ~
chemical components or
any AHM components '2) [
3) [ )
lO) Lo~o. X..~/..~/¢~,<,~,,S~' C-
cerdfy under peha~/ of law, that I have personally exarnined and am familiar with the infoma~ion~ugmitted on this and all attached documents, lbelieveth(~
PRINT Name & Title of Authorized Company Representative Signature / Date
BAKER, i IELD CITY FIRE DEP i :ITMENT
H DOUS MATERIALS INVEN"FORY Page/Yof~?
2) Common N~e: , ,~ ~ ~ ~ 3) ~T ~ (option~)
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ J Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chronic)
5) WAS~ C~SSIFICA~ON ~/ (3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICALSTA~ Solid__~ Uquid [ ] e~ [ ] Pure ~ M~ure [ ] W~te [ ] R~ioa~e
[
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum D~ly Amount: ~O00 1~ ~ g~ [ ] ~3 [ ] a) Contaner:
Average DaN Amount: ~ ~ curies [ ] b) Pressure:
Annual Amount: . ~O c) Tem~r~ure:
~gest Size'Cont~ner:
~ Days On Site ~G~ Circle~ich Months: ~J, F, M. A, M, J, J. A. S, O, N,
D
9) MITRE: DSt v ~ COMPO~NT ~ CAS · % ~ AHM
chemic~ componenm or
any AHM com~nen~ 2) [
3) [
CHEMICAL DESCRI~ION
1) INVENTORYSTA~S: New[ Addition[ ] Revision[ ] Deletion[ ] Check~chemi~isaNON~OESECR~ ~DESECR~
2) CommonN~e: ~,~ ~ ~ ~ ~ 3) ~T~(option~)
4) PHYSICAL & H~L~ PHYSICAL H~L~..
H~RD CATEGORIES Fire [ ] Rea~ive [ ] Sudden Relate of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.)
5) WASTE C~SSIFICA~ON ~/ .(3-digit code ~om DHS Form 8022} USE CODE ~
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure [ ] MinuTe ~ W. te [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACIM~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: 2~00¢ lbs ~ g~ [ ] ,3 [ ] a) Cont~ner:
Average D~N Amount: /~ cudes[ ] b) Pressure:
Annu~ Amount: ~.. c) Tem~r~ure:
~gest Size Container: ~0 ,-. ; ·
· Days On Sit~ ~&-- Circle ~ich Months: ~ J, F, M, A. M, J, J, A, S,.,,~'
9) MITRE: Mst COMPONENT CAS · % ~ ~M
the three most h~dous 1) [
chemi~ com~nen~ or
~y AHM com~nen~ '2)
3)
ce~'~ under pen~ of law, ~at / have pe~onal/y exam~n~ ~d am f~il/~ wi~ ~e" infomadon su~ on ~is ~d ~1 a~ch~ document.
submi.~ info~a~on is ~e. accurate, ~d complete. --~/~~
PRINT Name~Tit/e of A~orized Company Represenm~vo ~ Signa~re ~ D
BAKER [IELD CITY FIRE DEP i ITMENT
H DOUS MATERIALS INVENTORY Page~f~fZ__~
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~ Addition [ ] Revision [ ] ~letion [ ] Check ff chemi~ is a NON ~DE SECR~ ~] ~E
SECR~
[
2) Common N~e: ,~/~ ~ ~ "' 3) ~T · (op~on~)
Chemic~N~.: ~ ~ L ~ ~ AHM l ] CAS
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive[ ) Sudden Rele~e of Pressure [ ] Immedi~eHe~h (Ac~e) ~. ~layed He~h (Chronic) [ ]
5) WAS~ C~SSIFICA~ON ~/ .(3-digit code ~om DHS Fo~ 8022) USE CODE
6) PHYSICAL STA~ Solid ~. Uquid [ ] G~ [ ] Pure [ ] M~ure { ] W~te [ ] R~ioa~e [
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daly Amount: ~ I~ ~ g~ [ ] ~3 [ ] a) Contaner:
Average D~ Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: ~ ~ c) Tem~r~ure:
~gest Size'Cont~ner: ~
~DaysOnS~e ~ Circle~ichMont~s: ~ J, F, M, A, M, J, J, A, S, O, N. D
9) MITRE: Ust COMPONENT CAS ~ % ~ AHM
the three most h~ardous 1) ~ ~~ ~~ ~ ~ [
chemi~ com~nents or
3) [ l
10) Loc~ion ~~~
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New ~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~ [ ] ~DE SECR~ [
2) Common N~e: ~ ~ ~ ~ ~~ ~ ~ D 3) ~T ~ (option~)
Chemic~ Name: ~ ~C ~~ ~ ~yZ~ ~~ AHM[] CAS~ ~ ~/~
4) PHYSICAL & H~L~ PHYSICAL H~
H~RD CATEGORIES Fire [ ] Reactive [' ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.) [ ]
5) WASTE C~SSIFICA~ON ~ .(~digit code from DHS Form 8022) USE CODE ~
6) PHYSiCALSTA~ Solid [ ] Liquid ~ G~ [ ] Pure [ ] Minute ~ W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TiME AT FACtU~ UNtTS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~ ~ lbs [ ] g~ ~] ~3 [ ] a) Contaner:
Average Daly Amount: / ~ ~ cudes [ ] b) Pressure:
Annu~ Amount: ~ ~O c) Tem~r~ure:
~gest Size Container: ~ ~ · ... : . ..
· Days On Site ~ Circle ~ich Months: ~ J, F, M~~ A, M, J, J, A. S,,'0~' N; D
chemi~ com~nen~ or-
~y AHM com~nents ~). [ ]
3) [
ce~ under pen~ of Yaw, ~at I have pe~onafly examin~ ~d am f~ili~ wi~ ~e infoma~i~ on ~is ~d ~1 a~ch~ document. I believe
PRINT Name~ Title of A~orized Company Represen~ve ~'g~a~re/'
BAKER, i iELD CITY FIRE DEP ClTMENT
HAZ'J DOUS MATERIALS INVENTORY Page/_~.of z..z--~
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New ~/Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET
4) PHYSICAL & HEALTH PHYSICAL HE~[~TH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Releaseof Pressure [ ] Immediate Health (Acute)~ Delayed HeaJth (Chronic) [ ]
5) WASTE CLASSIFICATION ,(3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid ,[~ Uquid [ ] Gas [ ] Pure ~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FAClUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ..~/J"~'O~3 lbs ~ gal [ ] ft3 [] a) Contamer:
Average Daily Amount: '~ curies [ ] b) Pressure:
Annual Amount: ,~0 ~O ~b c) Temperature:
Largest Size'Container:
# Days On Site ;~'~'" Circle Which Months: ( AII'~~, J, F, M, A, M, J, J. A, S, O, N, D
9) MIXTURE: List COMPONENT CAS # % WT AHM
chemicaJ components or
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [/~ Addition [ ] Revision [ ] Deletion [ ] Check if chemicaJ is a NON TRADE SECRET,~ TRADE SECRET [ ]
4) PHYSICAL & HEALTH PHYSICAL HEALTH.~
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~] Delayed Health (Chronic) [ ]
5) WASTE CLASSIFICATION ~="~.-'/ (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid [~ Liquid [ ] Gas [ ] Pure [~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FAClUTY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~/~0 lbs j~l gal [] ~t3 [] a) Container:
Average Daily Amount: .~_..~..~ ~;~ ~ cudes [ ] b) Pressure:
Annual Amount: ~~ c) Temperature:
Largest Size Container: -/'~
# Days On Site ~ Circle Which Months: All Year. J, F. M, A, M, J, J, A, ~,.'0<[' N, D
9) MIXTURE: tist COMPONENT CAS ,~ % ~ AHM
chemica] components or
' cer~fy under penaJ~y of/aw, that I have personally examined and'am familiar with the infome~onsuqf~jttedon this and all attached documents. / believe
submitted informaO'on is true, accurate, and complete. ~ ~ ~.~~
PRINT Name &,~'it/e of Au~hodze~ Company Representae've Signature ~ Date
BAKER, i IELD CITY FIRE DEP TMEN'T
HAZARDOUS MATERIALS INVENTORY Page/7of~.__~
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New [,~ Addition [ ,] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET~ TRADE SECRET [ ]
2) Common Name: ~/i~'"'~/ ~'~-'! Cc ,~,.'., 3) DOT # {optional)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ ] Sudden Release of Pressure [ ] Immediate Health (Acute) ~ Delayed Health (Chronic) [ ] ·
5) WASTE CLASSIFICATION ~"2,// (3-digit code from DHS Form 8022) USE CODE
6) PHYSICAL STATE Solid [ ] Liquid ~ G~s [ ] Pure,.~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Dally Amount: J(~O lbs [ ] gal [~ /t3 [ ] a) Container:
Average Daily Amount: ~"'~) curies [ ] b) Pressure:
Annual Amount: ~ ~..00 c) Temperature: ~-~
Largest Size'Container:
# Days On Site .~'~=,(~'"" Circle Which Months: All Year, J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: [Jst COMPONENT _ CAS # % WT AHM
chemical components or
any AHM components 2) [
3) [ ]
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New[~ Addition [ ] Revision { ] Deletion [ ] Check if chemical is a NON TRADE SECRET [~ TRADE SECRET [ ]
2) Common Name: ~E:~'~--~/ ~ 3) DOT # (optional)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
'
HAZARD CATEGORIES Fire [ I Reactive [ I Sudden Release of Pressure [ ] Immediate Health (Acute) Delayed Hea~th (Chronic) [
5) WASTE CLASSIFICATION ,,~ ~,~/ (3-digit code from DHS Form 8022) USE CODE ///
6) PHYSICAL STATE Solid [ ] Liquid j~ Gas [ ] Pure~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: L~:;)O lbs [] gal ~ R3 {] a) Container:
Average Da~ly Amount: .~ / ,~ cudes [ ] b) Pressure:
Annual Amount: /4~0 c) Temperature:
Largest Size Container: ~ ~ ·
# Days On Site ~,~d"' Circle Which Months: ~ J, F, A, M, J, J, A, S,,'O','
N,
D
9) MIXTURE: Ust COMPONENT CAS # % WT AHM
the three most hazardous 1 )
chemical components or
any AHM components '2) [ ]
3). [ ]
submitted information is true, accurate, and complete. ~na~ ~
PRINT Name ~ Title of Authorized Company Representative '
BAKER, i IELD CITY FIRE DEP ITMENT
HAZARDOUS MATERIALS INVERTORY Page/.~_of
Business Name ,~~ ~4 ~ ~~ Address ~ ~/~ ~ ~/~&~ CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New~ Addition [ 1 Revision [ ] ~letion [ ] Check ffchemi~ is e NON ~OE SECR~
4) PHYSICAL & H~L~ PHYSICAL H~
H~RD CA~GORIES Fire [ ] Reactive [ ] Sudden Relate of Pressure [ ] Immedi~e He~h (Acme)~layed He~h (Chronic) { ]
5) WAS~ C~SSIFICA~ON ~ (3-digit code ~om DHS Fo~ 8022) USE CODE
7) AMOUNT A.O ~UE AT ~AC~U~ UN~TS OF U~SURE a) STOOGE CODES
M~imum O~ty Amount: ~OOO I~ ~ g~ [ ] fi3 [ ] ~) Contaner:
Average D~Iy Amount: /~ O ' curies [ ] b) Pressure:
Annu~ Amount: ~OOo c) Tem~r~ure:
L~gest Size'Cont~ner:
Days On Site ~ Circle~ich Months: ~J, F, M, A, M, J, J, A. S, O. N.
D
9) MITRE: Ust COMPONENT CAS ~ ~ AHM
the three most h~dous 1) ~/~ .~ ~/~ /~70-7~-~ ~.~
chemic~ componen~ or
any AHM com~nents 2) [
3) { ]
lO)
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New~ Addition [ ] Revision [ ] Deletion [ ] Check ~ chemi~ is a NON ~DE SECR~
2) Common N~e: ~ ~ / ~ ~~ 3) ~T ~ (o.ion~)
Chemic~ Name: ~~ /~ A~ AHM [ ] CAS
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CATEGORIES Fire [ ~ Reactive[ ) Sudden Rele~eof Pressure [ ~ Immedi~sHe~h (Acute) ~ ~layed He~h
(Chron.)
5) WAS~ C~SS[FICA~ON ~/ (3-digit code from OHS Form 8022) USE CODE
6) PHYSICAL STA~ Solid ~ Liquid [ ] G~ [ ] Pure [ ] Mi~ure~ W~te [ ] Radioa~ive
7) AMOUNT AND TIME AT FAClU~ UNITS OF M~SURE 8) STOOGE CODES
a~imum Daily Amount: /~ ~O lbs ~ g~ [ ] ~3 [ ] a) Contaner:
Average Daly Amount: ~ O cunes[ ] b) Pressure: /
Annu~ Amount: ~ c) Tem~r~ure:
~gest Size Container: ~ ' ,..
· D~ys On Site ~ Circle~ich Months: AII Ye~, J, F, M~~ A, M, J. J, A. S.,'~<:' N: D
9) MITRE: Ust COMPONENT CAS · % ~ ~M
the three most h~dous 1) [ ]
chemi~ com~nenm or
~y AHM com~nenm '2) [
a)
ce~ Under pen~ of law, ~at I have pe~ona/ly exam~n~ ~d am f~ili~ wi~ ~e infoma~on su~ on ~is ~d ~1 a~ch~ documen~ / believe
PRINT Name ~ Title of A~orized Company ~epresenm~ve ~ ~g~re ~ Dam
· BAKER :IELD CITY FIRE DEP i FITMENT
HAZARDOUS MATERIALS INVEhTrORY
Page/?of
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New,J~ Addition [ I Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ~j' TRADE SECRET
2) Common Name: /~-'~'~/----"'~'~'~ 3) DOT # (optional)
4) PHYSICAL & HEALTH PHYSICAL H .F_A~TH
HAZARD CATEGORIES Fire [ [ Reactive [ i Sudden Release of Pressure [ ] Immediate Health (Acute) ~/~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION ~'-~'"~/ (5.digit code from OHS Form 6022) USE CODE
6) PHYSICAL STATE Solid ~' Liquid I ] Gas [ ] Pure [~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY ~ UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~/~'~-0~-~ lbs ~ gal [ ] fl3 [ ] a) Container:
Average Dally Amount: ,.~- ,~ 0 curies [ ] b) Pressure:
Annual Amount: ~/f¢'~ ~ ~ ~ c) Temperature:
Largest Size'Container:
# Days On Site _~"' Circle Which Months: ~J, F, M, A, M, J, J, A, S, O, N, D
9) MIXTURE: List ~ COMPONF_..NT CAS # % WT AHM
chemical components or
any AHM components 2)
3) [ ]
CHEMICAL DESCRIPTION
1) INVENTORY STATUS: New~ Addition [ ] Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ~j TRADE SECRET
2) Common Name: c ~'/'~ ~:;) 3) DOT # (optional}
4) PHYSICAL & HEALTH PHYSICAL HEALTH..
HAZARD CATEGORIES Fire [ ] Reactive [ 1 Sudden Release of Pressure [ ] Immediate HeaJth (Acute) ~ Delayed Health (Chronic)
5) WASTE CLASSIFICATION ,~'~"/ (5-digit code from DHS Form 8022) USE CODE //
6) PHYSICAL STATE Solid .~] Liquid [ ] Gas [ ] Pure ~ Mixture [ ] Waste [ ] Radioactive [
7) AMOUNT AND TIME AT FAClUTY UNITS OF MEASURE e) STORAGE CODES
Maximum Daily Amount: ~t¢O tbs ~ gal I ] ~t3 [ ] a)
Container:
Average Daily Amount: ~ cudes [ ] b) Pressure:
Annual Amount: ~..~0 c) Temperature: ~_~
largest Size Container: ~~'-~ .'
# Days On Site .~'~,~' Circle Which Months: All Year, J, F, M, A, M, J, J, A, S.,'O',~ N, D
9) MIXTURE: list COMPONENT CAS # % w'r AHM
chemicaJ components or
~ny AHM components '2) [
3)
'~er~fy under penaJty of Jaw, that I have personally exarmned and am familiar with the infoma~n su~rnBed on this and ail attached documents. I believe
submittedinformat~onist~'ue, accurate, andcomplete. ~.~i~,~ ~~
PRINT Name ~[ Title of Authorized Company Representative ' Signature ( Date
. . BAKER i :IELD CITY FIRE DEP RTMENT
HAZARDOUS MATERIALS INVEN-'i'ORY
Page2.Oof Z,Z--
CHEMICAL DESCRIPTION
1 ) INVENTORY STATUS: New~ Addition [ I Revision [ ] Deletion [ ] Check if chemical is a NON TRADE SECRET ~ TRADE SECRET [ ]
2) Common Name: . ,~,.,~j,J)c,. J"~ ,3) DOT # (optionaJ)
4) PHYSICAL & HEALTH PHYSICAL H ~EA}TH
HAZARD CATEGORIES Fire { ] Reactive. [ J Sudden.Release of Pressure [ ] Immediate Heetth (Acute) ~J Delayed Health (Chronic) {'
5) WASTE CLASSIFICA'RON ,5'" ~3..~/ (3-digit code from DHS Form 8022) USE CODE
$) PHYSICAL STATE Solid .~ Liquid [ ] Gas { ] Pure ~ Mixture [ ] Waste [ ] R~lioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNITS OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: 2~ 000 lbs ~' gal [ ] ~t3 [ ] a) Container:
/
Average Daily Amount: /t/' ~eO curies [ ] b) Pressure:
Annual Amount: //~.. Ooa c) Temperature:
Largest Size'Container:
# Days On Site ,-~'" Circle Which Months: ~, F, M, A, M, J, J, A. S, O, N, D
9) MIXTURE: List COMPONENT CAS # % WT AHM
the three most hazardous T) [ ]
chemical components or
any AHM components 2) [ ]
3) [ ]
CHEMICAL DESCRIPTION
1 ) INVENTORY STATUS: New,~ Addition { ] Revision { ] Deletion [ I Check if chemical is a NON TRADE SECRET ,~ TRADE SECRET
[
2) Common Name: ~..~.~)..~ .~g~v/ 3) DOT # (optional)
4) PHYSICAL & HEALTH PHYSICAL HEALTH
HAZARD CATEGORIES Fire [ ] Reactive [ I Sudden Release of Pressure [ ] Immediate Health (Acute) D~ Delayed HeaJth (Chronic) [ ]
5) WASTE CLASSIFICATION ~",~/ (3-digit code from DHS Form 8022) USE CODE //x/
6) PHYSICAL STATE Solid ~ Liquid [ ] Gas [ ] Pure [,~ Mixture [ ] Waste [ ] Radioactive [ ]
7) AMOUNT AND TIME AT FACILITY UNI~S OF MEASURE 8) STORAGE CODES
Maximum Daily Amount: ~/'~,~'/¢10 lbs [~ gal [ ] ft3 [ ] a) Container: /'~' ·
Average Daily Amount: ~.~,. ~ curies [ ] b) Pressure: /
Annual Amount: /~ c) Temperature:
Largest Size Container:
# Days On Site ~'-~- Circle Which Months: ~ J. F. M:' A, M, J, J. A,-S,,~)<:' N,' D
9) MIXTURE: List COMPONENT CAS # % WT AHM
chemical components or
any AHM components '2) [ ]
i ~er~fy under penaJty of/aw, that I have personally examined and am familiar with the infomatJonsu~;~f~i'/ted on this and ail attached documents. I befieve th~
submittsdinformat~onJstrue, accurate, andcompiete. ~~~.~,,~j~
PRINT Name & Title of Authorized Company BepresentatJve Oats
· . BAKERCi iELD CITY FIRE DEPik ITMENT
H DOUS MATERIALS INVEN-i'ORY
Pagel/of Z.~'Z--
CHEMICAL DESCRI~ION
1) IN~NTORY STA~S: New ~] Addition [ ] Revision [ ] ~letion [ ] Check E chemi~ is a NON ~DE SECR~ ~ ~DE SECR~ [ ]
2) Common N~e: ~/~.~ ¢~ ~ 0 ~ 3) ~T ~ (opdona)
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ I Reactive [ J Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) .~] ~layed He~h (Chronicl [
5) WAS~ C~SSIFICA~ON ~/ ,(3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICAL s'rA~ Solid ~ Liquid [ ] G~ [ ] Pure~ M~ure [ ] W~te [ ] R~ioa~e [ ]
7) AMOUNT AND ~ME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daly Amount: ~/¢0 I~ ~ g~ [ ] ~3 [ ] a) Contaner:
Average O~ Amount: ~ / O ~ curies [ ] b) Pressure:
Annu~ Amount: ~ ¢e c) Tem~r~ure:
~gest Size'Container:
¢ DaysOnSite ~ Circle~ich Months: ~J, F, M, A, M, J, J, A, S, O, N,
D
9) MITRE: Ust COMPONENT CAS ~ % ~ AHM
the three most h~ardous 1 ) [
chemic~ components or
any AHM com~nen~ 2) [ ]
3) [ ]
CHEMICAL DESCRI~ION
1) INVENTORYSTA~S: New Addition[ ] Revision[ ] Deletion[ ] Check~chemi~isaNON~DESECR~ ~DESECR~ [ ]
2) Common N~e: ~/~ ~ 3) ~T · (opfiona)
Chemic~ Name: , ~ ~/ ~' AHM [ ] CAS ·
4) PHYSICAL & H~L~ PHYSICAL H~
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.) [ ]
5) WAS~ C~SSIFICATION ~/ (3-digit code ~om DHS Form 8022) USE CODE ' //
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ Mi~ure [ ] W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~Od lbs [ ] g~ [ ] ~3 [ ] a) Contaner:
Average Daly Amount: ~ ~ cudes [ ] b) Pressure:
Annu~ Amount: /~ ~0 c) Temper~ure:
~gest Size Container: ~ ' ...
9) MITRE: Dst COMPONENT CAS · % ~ ~M
chemi~ com~nen~ or
~y AHM com~nenm '2) [
3) [ ]
~e~ und er pen.~of I. w,.atlha vepemo nallyexa m,n~ ~dam f~i/i~ wi.~e in fom a~~ on .is ~d~la.ch ~ doc um en
,, , BAKER, i IELD CITY FIRE DEP i I:ITMENT
H/ -'=JCRDOUS MATERIALS INVERTORY PageZ fz. .--
CHEMICAL DESCRI~ION
1) IN~NTORYSTA~S: New~ Addition[ ] Revision[ ] ~letion[ ] Check Echemi~isaNON~DESECR~ ~ESECR~ [ ]'
2) Common N~.: '--"~~~ ~ 3) ~T * (opfion~)
4) PHYSICAL & H~L~ PHYSICAL H~L~
H~RD CA~GORIES Fire [ ] Reactive [ ] Sudden Rele~e of Pressure [ ] Immedi~e He~h (Acme) ~] . ~layed He~h (Chronic) [ ]
5) WAS~ C~SSIFICA~ON ~/ (3-digit code from DHS Fo~ 8022) USE CODE
6) PHYSICALSTA~ Solid [ ] Liquid ~ G~ [ ] Pure [ ] M~ure ~ W~te [ ] R~ioa~Ne [ ]
7) AMOUNT*ND ~E AT F*C~U~ ,/ UN~TS O~ M~SURE., S) STOOGE COOLS
M~imum O~ly Amount: /U0 I~ [ ] g~ ~ ,3 [ ] .) Contaner:
Average Om~ Amount: ~ curies [ ] b) Pressure:
Annu~ Amount: ~0 c) Tem~r~ure:
~gest Size'Container:
¢ Days On Site ~ Circle~ich Months: AllYe~, J, F, M, A, M, J, J, A, S, O, N, D
9) MITRE: Ust ~ COMPONENT CAS ~ % ~ AHM
chemic~ components or
3) [ ]
CHEMICAL DESCRI~ION
1) INVENTORY STA~S: New [ ] Addition [ ] Revision [ ] Deletion [ ] Check ~chemi~ is a NON ~DE SECRet] ~DE SECR~ [ ]
Common N~e: ~¢~ ~0~ ~ 3) ~T~
2)
(option~)
4) PHYSICAL& H~L~ PHYSICAL H~L~,,
H~RD CATEGORIES Fire [ ] Reactive [ ] Sudden Retake of Pressure [ ] Immedi~e He~h (Ac~e) ~ ~layed He~h (Chron.) [ ]
5) WASTE C~SSIFICATION ~/ .(~digit code kom DHS Form 8022) USE CODE
6) PHYSICALSTA~ Solid ~ Liquid [ ] G~ [ ] Pure ~ Minute [ ] W~te [ ] Radioa~ive [ ]
7) AMOUNT AND TIME AT FACIU~ UNITS OF M~SURE 8) STOOGE CODES
M~imum Daily Amount: ~ Ibs~ g~ [ ] fi3 [ ] a) Contaner: ~ ·
Average D~ly Amount: ~ - ~cunes [ ] b) Pressure:
Annu~ Amount: ~ c) Temper~ure:
~gest Size Container:
9) MITRE: Ust COMPONENT CAS ~ %
the three most h~dous 1) [ ]
chemi~ com~nen~ or
~y AHM com~nents '2) [
3) [ ]
ce~ under pen~ of law, ~at I have pe~onafly examin~ ~d am f~i/i~ wi~ ~e infom~ ~is ~d ~1 a~ch~ document. I believe
submi., info~afion is ~e, accumte, ~d complete. ~ ~ ~ ~
PRI~ Nam~ Title of Au~orized Company ~epresen~ve