HomeMy WebLinkAboutBUSINESS PLAN 1/23/1998
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A FIRE HYDRANT
B GAS f'fAIN
C EJÆCTRICAL MAIN
D WATER MAIN
E GASor.INE & PAINT STORAGE
F OXYGEN BOTTLE STORAGE
G ACETYl.ENE ßOTTLE STORAGE
H RECORDS &: FURNITUJŒ STORAGE
I OFFICE
J WAREHOUSE
K PROPANE TANK
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'FINANCE DEPARTMENT
CITY OF BAKERSFIELD
P.O, BOX 2057
BAKERSFIELD, CALIFORNIA 93303
¡'\ETUF~N ::;ERV!CE
REC1UESTED
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NATcaðo 9330720a2 ~500 06 06/0ð/00
RETURN TO SENDER
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ðç~a GOLDEN STATE HwY
BAKERSFIELD CA Q330ð-Q532
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Per
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Hazardous Materials/Hazardous Waste Unified Permit
CONDITIONS OF PERMIT ON REVERSE SIDE
This permit is issued for the following:
'::Hazardous Materials Plan
round Storage of Hazardous Materials
q~gement Program
mm'," Waste
2280 S UNION
NATCO
PERMIT ID# 01S-021.o00872
LOCATION
Issued by:
Bakersfield Fire Department
OFFICE OF ENVIRONMENTAL SER VICES
1715 Chester Ave., 3rd Floor
Bakersfield. CA 93301
Voice (805) 326-3979
FAX (805)326-0576
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ffice of ental Servi es
June 30, 2000
Approved by:
Expiration Date:
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Manager DAVID HAGANS
Location: 2280 S UNION AVE
City'" BAKERSFIELD
JAN 2 3 1998
Bxr;
sPhone:
p : 102
id: 23B
SiteID: 215-000-000872
837-~/co
( 8 0 5 ) ì..7 r; - 4 I 4-6
CommHaz : Moderate
FacUnits: 1 AOV:
NATCO
CommCode: BAKERSFIELD STATION 05
EPA Numb:
SIC Code:3441
DunnBrad:16-159-3055
Emergency Contact / Title Emergency Contact / Titlè
DAVID HAGANS / MANAGER "iJJ7-'/e-O MIKE STUCK / FIELD SUPER
Business Phone: (805 ) 3.ê:5 1116x Business Phone: (805) JiC 11 H;x £337- ~I '7C
24-Hour Phone : (805) 836 -~x '9'12.6 24-Hour Phone : (805) 836-2118x
Pager Phone : (805 ) 632-0756x Pager Phone : (805) 632-4168x
Hazmat Hazards: Fire Press ImmHlth
Emergency Directives:
?MOVE TO 2280 S UNION AVE. NEW #837-4100. PLAN SENT.
F Hazmat Inventory One Unified List l
~ MCP+DailyMax Order All Materials at Site l
Hazmat Common Name. . . EPA Hazards DailyMax MCP
PROPANE F P IH G 36390 FT3 Hi
ACETYLENE F P IH G 100 FT3 Hi
OXYGEN F P IH G 220 FT3 Low
ARGON F P IH G 600 FT3 Min
CARBON DIOXIDE F P IH G 400 FT3 Min
I, j)/Wrp H/"(Ge1NJ:. Dc her'3b! cerU~"t· 1h2.t I f1¿iV~
(T)'pe ~r ¡¡11m r,;:lrr,9ì
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F Inventory Item
¡:::= COMMON NAME /
PROPANE - ~c;1l:)
SiteID: 215-000-000872 1
Facility Unit: Fixed Containers on Site 1
0001
CHEMICAL NAME
G-'t'G. FlXef) (:>,e.e J'J'.
C' Y L I /V D&-e
Days On Site
365
Location within this Facility Unit
.... CORNER OF YARD
H·e.
Map:
Grid:
CAS #
74-98-6
STATE - TYPE
Gas Pure
PRESSURE
Ambient
TEMPERATURE
Ambient
CONTAINER TYPE
FIXED PRESS. CYLINDER
Largest Container
7¡!::.Oc.l.CTO 41843.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
36390.00 FT3
Daily Average
43668.00 FT3
%-wt. EHS CAS #
92.00 Propane No 74986
5.00 Propylene No 115071
3.00 n-Butane Or Butane Mixture No 106978
HAZARDOUS COMPONENTS
TSecret EHS BioHaz Radioactive/Amount, EPA Hazards NFPA ,USDOT# MCP
No No No No/ Curies F P IH / / / Hi
HAZARD ASSESSMENTS
\ -..
F Inventory Item 0002
= COMMON NAME / CHEMI CAL NAME
ACETYLENE
Facility Unit: Fixed Containers on Site 1
Days On Site
365
Location within this Facility Unit
"..,QF SHOP
~~
Map:
Grid:
CAS #
74-86-2
- TYPE
Pure
PRESSURE ---- TEMPERATURE
Above Ambient Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
100.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
100.00 FT3
Daily Average
2400.00 FT3
%-wt. EHS CAS #
100.00 Acetylene No 74862
HAZARDOUS COMPONENTS
TSecret EHS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Hi
HAZARD ASSESSMENTS
-2-
01/06/1998
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SiteID: 215-000-000872 1
Facility Unit: Fixed Containers on Site 1
F NATCO
p= Inventory Item 0003
= COMMON NAME / CHEMICAL NAME
OXYGEN
Days On Site
365
Location within this Facility Unit
EJ!ff OF SHOP
5
Map:
Grid:
CAS #
7782-44-7
STATE - TYPE
Gas Pure
PRESSURE ---- TEMPERATURE
Above Ambient Ambient
, CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
249.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
220.00 FT3
Daily Average
5280.00 FT3
%Wt. EHS CAS #
100.00 Oxygen, Compressed No 7782447
HAZARDOUS COMPONENTS
TSecret EHS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Low
~ ,-, .
HAZARD ASSESSMENTS
p= Inventory Item 0004
= COMMON NAME / CHEMICAL NAME
ARGON
Facility Unit: Fixed Containers on Site 1
,
Days On Site
Location within this Facility Unit
:;N OF SHOP
S
Map:
Grid:
CAS #
7440-37-1
STATE - TYPE
Gas Pure
PRESSURE ---- TEMPERATURE
Above Ambient Ambient
CONTAINER TYPE
PORT. PRESS. CYLINDER
Largest Container
762.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
600.00 FT3
Daily Average
7200.00 FT3
HAZARDOUS COMPONENTS
I~
CAS # I
7440371
I l~~tooIArgon
TSecret EHS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Min
HAZARD ASSESSMENTS
-3-
01/06/1998
e
--
SiteID: 215-000-000872 l
Facility Unit: Fixed Containers on Site l
f NATCO
p= Inventory Item 0005
= COMMON NAME / CHEMICAL NAME
CARBON DIOXIDE
Days On Site
Location within this Facility Unit
S OF SHOP
Map:
Grid:
CAS #
124-38-9
STATE - TYPE
Gas Pure
PRESSURE ---- TEMPERATURE
Above Ambient Cryogenic
CONTAINER TYPE
INSUL.TANK / CRYOGENIC
Largest Container
400.00 FT3
AMOUNTS AT THIS LOCATION
Daily Maximum
400.00 FT3
Daily Average
200.00 FT3
%Wt. EHS CAS #
100.00 Carbon Dioxide No 124389
HAZARDOUS COMPONENTS
TSecret EHS BioHaz Radioactive/Amount EPA Hazards NFPA USDOT# MCP
No No No No/ Curies F P IH / / / Min
HAZARD ASSESSMENTS
, '
-4-
01/06/1998
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I
p= Notif./Evacuation/Medical
r=: A,genCY Notification
CALL 911
SiteID:
¡=:: Employee Notif./Evacuation
VERBAL ON OUTDOOR SPEAKER
I Public Notif./Evacuation
VERBAL ON OUTDOOR SPEAKER
I Emergency Medical Plan
. MERCY HOSPITAL - 2215 TRUXTUN AVE c 327-3371
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215-000-000872 =¡
Fast Format =¡
Overall Site =¡
OS/21/1990 ]
1
1
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OS/21/1990
OS/21/1990
OS/21/1990
01/06/1998
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F NATCO
I
p= Mitigation/Prevent/Abatemt
Release Prevention
SiteID: 215-000-000872 1
Fast Format 1
Overall Site 1
01/24/1996
MONTHLY WALK THRU AND VISUAL INSPECTION OF FACILITIES BY MYSELF (DAVID
HAGANS). ALL HAZARDOUS MATERIAL FOUND OUT OF ITS RESPECTIVE PLACE RETURNED
TO THE PROPER AREA AT THAT TIME. OXYGEN AND ACETYLENE BOTTLES IN RACKS
CHAINED. PROPANE IN STEEL TANKS.
Release Containment
01/24/1996
ALL PRESSURIZED FIXED AND PORTABLE CONTAINERS HAVE SAFETY RELEIF VALVES.
AREA EVACUATION AND/OR SITE EVACUATION PROCEDURES ARE FOLLOWED WITH
NOTIFICATION OF FIRE DEPARTMENT IF FIRE OR EXPLOSION OCCURS.
Clean Up
01/24/1996
CLEAN-UP OF WASTE MATERIAL FROM REPAIRED EQUIPMENT TO BE HANDLED BY
CUSTOMER.
...
Other Resource Activátion
01/24/199'6
. ,. '"
NATCO EMPLOYEES EMERGENCY EVACUATION PLAN FROM ALL BUILDINGS TO MAIN EXIT AT
~ _~. ~ J ,...K OF PROPERTY.
¡;..JêST B~Þd
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01/06/1998
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p= Site Emergency Factors
Special Hazards
SiteID: 215-000-000872 ì
Fast Format ì
Overall Site ì
01/24/1996
CUSTOMERS REPAIR EQUIPMENT. MAY CONTAIN UNKNOW HAZARDOUS WASTE.
Utility Shut-Offs
St/J
A) GAS - .. CORNER OF Fn2 rum]?:: Ø?rrrre
B) ELECTRI CAL - SW CORNER OF ~ (}r?7re ¿ S N
C) WATER - PI-f5RCE RD & EN'fR....... BKIVE KCN CdNC'd if'
D) SPECIAL - OXYGEN & ACETYLENE STORAGE» SIDE OF
E) LOCK BOX - NO S
04/18/1997
c~,-^le~ 0 F VA-€ D
¡2'¿o/~TY
SHOP
Fire Protec./Avail. Water
04/18/1997
PRIVATE FIRE PROTECTION - FIRE EXTINGUISHERS AT VARIOUS LOCATIONS
lèO ¡ /<o¿rH (IF F"e()/,(:;-~ry UNe orV ~/V("CJA.l I"lve, ~ ..s-o I
/. sO(./iÍ"f OF P'¿~~ìY C(-'Vr (?-'V V.lVIr:JN ~,
FIRE HYDRANT - C8fäŒþ' (¡Ii' PIRRcl:!, RD ~Trn ~y, DRIVE.
:,"~ 1:::==::::'
','.. ,.,
Building Occupancy Level
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01/06/1998
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SiteID: 215-000-000872 l
Fast Format l
Overall Site l
04/18/1997
/ f NATCO
I
F Training
Employee Training
WE HAVE tI EMPLOYEES AT THIS LOCATION.
(0
WE HAVE MATERIAL SAFETY DATA SHEETS ON FILE IN THE OFFICE AND SHOP.
BRIEF SUMMARY OF TRAINING: MONTHLY SAFETY MEETING WITH ALL FIELD AND
TECHNICIAN SERVICE EMPLOYEES. COVERING SAFETY TOPICS CURRENTLY IN NEED AT
TIME.
Page 2
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01/06/1998
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CITY OF BAKERSFIELD
OFFICE OF ENVIRON~IENTAL SERVICES
1715 Chester Ave., Bakersfield,CA (805) 326-3979
INSTRUCTIONS:
1, To avoid further action, return tills fonn within 30 days of receipt.
2. TYPEIPRINT ANSWERS IN ENGLISH.
3, Answer the questions below for the business as a whole.
4, Be as brief and concise as possible,
SECTION 1: BUSINESS IDENTIFICATION DAT A
BUSINESS NA1vŒ: ,LY~:Tc_~_.,-:,~._
LOCATION: _ 22 ~..9__ S· u':J!...!..o,rV A-{/e,
MAILING ADDRESS: po, !30l\ t¡O?00 1?Arr{',éS-rr~L..¡) L.A. 9JJ6 C(-O'?GO
CITY: EAke'¿SF/G'7-D STATE: [,;4, ZIP:933D? PHONE: 637-'1/0-0
DlJN & BRADSTREET NillvffiER: /6- 159 - 30$"5' SIC CODE: 37"~ L
PRIMARY ACTIVITY: /HF&: t¡ '¿erJ.Af,¿' O/cha/J é(Qr...e /¡ð.
OWNER: L.eF' 4-7A-E' f./VC.
NfARING ADDRESS: PC', t3o~ 5/66
Vé'/\~"ê/'7-, C'/'/, 93005
SECTION 2: EMERGENCY NOTIFICATION
CONTACT TITLE BUS, PHONE 24 HR. PHONE
1. D.Rvrò 17-4G"":'¡A¡S ø.t:l/Y Jf G:-6-/€ 637- 'f / c.-v 836-9 o/¿ <ó
2, /ll/CHA--t::-?- S'TLt'C' /C' H~2D SU fJ v , 83) - C7 /or:;; 93b- 2.1 / B
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HAZARDOUSMATERMLSMANAGEMENTPLAN
SECTION 3: TRAINING
NUMBER OF EMPLOYEES: /0
MATERIAL SAFETY DATA SHEETS ON FILE: / AJ ~ff,c:e-
BRIEF SUMNfAR Y OF TRAlNlNG PROGRAM:
Ø'/O.NrH-'C-Y SAf?;/'/ mce ríA/(- ú.J I rH
To¡iJ,cs Cw'¿,(leNJC,Y fN Néé:'ù p.f-'f
A-u- &-fl "LJ c. c yee,j C c v8<! / ,IV t;..
Tï F1!?C- .
SECTION 4: EXEMPTION REQUEST
I CERJIFY UNDER PENALTY OF PERJURY THAT ¥y BUSINESS IS E~:MPT FROM
THE REPORTING REQUIREN1ENTS OF CHAPTER 6,95 OF THE "CALIFORNIA HEALTH
& SAFETY CODE" FOR THE FOLLOWING REASONS:
WE DO NOT HAJ.'IDLE HAZARDOUS MATERIALS,
)( WE DO HANDLE HAZARDOUS MATERIALS, BUT THE QUANTITIES AT
,
NO TIME EXCEED THE MINIMUM REPORTING QUANTITIES,
OTHER (SPECIFY REASON)
SECTION 5: CERTIFICATION
I, DAlND ¿;.,j. tfArsiri"v.s CERTIFY THAT THE ABOVE
INFORMATION IS ACCURATE. I ~TIERSTAND THAT THIS INFORMATION WILL BE
USED TO FULFIT..L MY FIR1\1' S OBLIGATIONS UNDER THE "CALIFORNIA HEALTH
AND SAFETY CODE" ON HAZARDOUS MATERIALS (DIY 20 CHAPTER 6.95 SEe. 25500
ET AL,) AND THAT INACCURATE INFORMATION CONSTITUTES PERJURY.
~ '- - - -
SIGN~
~/Ý..4'¡;;::¿> 4
TITLE
I /;'2/~
DATE
2
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SECTION 6: NOTIFICATION At'ID EVACUATION PROCEDURES
A. AGENCY NOTIFICATION PROCEDURES:
CÆtA- q r f
B. ENfPLOYEE NOTIFICATION AND EVACUATION:
l}e~6kc ~N 0 c.rròÇT"O~ .5 Pc:-?:f kL"P?
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-
C. PUBLIC EVACUATION:
IYe'¿ 6AG- 0 N () c/ r D f%/'¿ 5' ßc::;z::¡./C'et?('
D, EMERGENCY MEDICAL PLAN:
¡tfe¿cy !f6?s/:)¡-r/f'l,- -¿¿IS" -rA:!aKr.o-0 /fV(:,
3
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,3<'7- 3371
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HAZARDOUS~~TEIDALSMANAGEMENTPLAN
SECTION 7: i\1ITIGA nON, PREVENTION AND ABATEMENT PLAl'l
A. RELEASE PREVENTION STEPS: ØC-1/77Tc...Y c:JI"h;.K(~~ f ¡/Isarfc... (,-Nc.J~nPN
of f?¢c,Ç/"-/~. /fu- ;??~r~ ~U.-'\7.D "to ~ (/&e7" t7f', fJ~C'e
I-S 1?c:-ru4...veD Tr:> rrJ ,¿1?s'æCTJr/f' A~eA. D-,c'( ~ ~"7". l3o~C:"JP IN
;è A-c 'JCS- {' ¡.{;Hf,AJ c: Ò, P~Ð ¡iJA/'V C" J ...v s TO ¿ffG.e T:;Z7 ¡'V ~ .
B. ,RELEASE CONT~NŒNT A1'ID/OR.MINL'vllZATION: A<-<-. ¡CÎJ(cfJ 9 ?O~Trl-6{'e..
P¿c 55 uæ r ?er.) cø-.JrAr""e'¿J rfrNe: 5AFr:.-r¡ Kf:'t.-I<:F'r vri7:...ve~. /1'¿é"A c=v,.{-C"u,A-rrccAj
r\ND/c;re s/,;C' 6.(/,4;CV("f'T/i!?,N Fp(fo"C>,JC'D N/<K- NtJT¡F,CA-r¡ON (1F (::=-rdlf'> h?ï:
, F Frcfc o,,{! EJcPc..-OSfDAJ Q ~C'coeJ'
C. CLEAN-UP PROCEDURES:
C Le,o...v .. c.vð c,c CJ/'1-S7C",.n',;If- í'2;-~ r ,-f-cJ P¿& r.;7 r" ¡t! e:~ Æ f,{J e D ~ I ¡.:l P'f r /\I -,-
TO (be:- f-{-A,/Vt) c.eD 6 y raS'7?:'~~
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SECTION)j:{JTILITY SHUT-OFFS (1JOCATION OF SHUT-Off~ ,AT YOUR FA,CJ¡ITY)
NATURAL GASIPROPA1"Œ:
s, v.l. Co ¿~e-¡f} £) F {) FF('Ce
ELECTRICAL: .$.w. cc"¿Nd ~r DFPrce 7' ,S.t.J, coÆß~ or Y/1,¿lJ
WATER: AI, w, P¡!oPe¿-¡'y UN(' DN (.//LIfO/V' I'we·
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LOCK BOX: YE~ IF YES, LOCATION:
SECTION 9: PRIVATE FIRE PROTECTIONI\V ATER A V AlLABILITY
A.
PRIV A IE FIRE PROTECTION:
NOtVé:.
B, WATER AVAILABILITY (F1RE HYDRA1~l):
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CITY OF BAKERSFIELD
OFFICE OF ENVIRONìVIENT AL SERVICES
1715 Chester Ave., Bakersfield, CA. (805) 326-3979
HAZARDOUSML~TEIDALS~~lORY
FACILITY DESCRIPTION
CHECK IF BUS~'ESS IS A FA~\1 [ ]
BUSINESSNAt\iE N.4TC ()
FA,CIlJTY NAt\1E /'IA- TC 0
'SITE ADDRESS ¿X;;¿2ro ~.:. (/rVrc?/V Ac'e
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CITY
KÆ¿é}-d~r¡-@-f)
STATE OA. ,
ZIP 933C'7
NATURE OF BUSINESS /4'rG ~ ;t1e/A('¡f Ô/'c-~r&'-rJ é---æw(/.
SIC CODE
'2., 'f c.-j 1
DUN & BRADSTREET NUMBER / b-IS9 - 3 Q-S'S
O\VNtRJOf[r~·.TQR (<;:¡:: IY/A--e- INC,
PHONE
~~, I'K. k'er.)
33-059.J
MAILING ADDRESS P.O, (JOX 5/60
CITY (JeA.),C/'Æ,4
STATE CA-,
ZIP '93CéJS
E.M:ERGENCY CONTACTS
NAJ.\1E D;tvrõ ffAE41'V' J
TITLE /ß/4NA-c;:e~
BUSINESS PHONE <[33) - c¡ í þ7:)
24 HOUR PHONE 8" .!J 6 -7' r 2 b
NAJ.'vŒ Ø/C~L
5Th:' C ré
TITLE fi'r::;-vJ S- c¿"1'.:/(;/.
BUSINESS PHONE
tß .J 7 - c¡'/C7D
24 HOu"R PHOl'i"E ~.2 b-¿ / J ð"
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.rp. .
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HAZARDOUS MATERIALS L'fVENTORY
.,
Business Name
/'IA-TeO
Page_of_
Address 2.2. éi't) S. ¿PAl 10.-..) A-<:Ie. IJAKt"A!.J~f:'Z¡} CA. 7:3}l)
CHEMICAL DESCRIPTION
2) Corrunon Name:
P'¿OPA,v e
I) rNVENTOR Y ST A ruS: New [ ] Addition [ ] Revision D<rDeletion [ ] Chedc if chemical is a NON Trade Secret [)(1 Trade: &act [
J) DOT Ii (optional)
Chemical Name:
PÆo?,cq,.-vc
'-I) Physical & Health
Hazard Categories
Al-J},1[ ]. CAB Ii
7Lf-CJf3-{P
PHYSICAL HEAL rn
Fire [X} Re.active [ J Sudden Release oêPressure [)<J Immediate Health (Acute) [ ] Delayed Health (Chronic) [
5 ) WASTE ClASSIF1CA TION
(J-digit cOOe from DHS Form 8022)
ó) PHYSICAL STATE
Solid [ ,
Liquid [
Gas [X]
7) AJ.\1OlJNT A.t.'ID TIME AT FACILITY
!.JNITS OF NŒ.ASURE
LOO [ ] Gal [)(1 ft3 [
Curies [ ]
Maximum Daily Amount
A verage Daily Amount
Annual Amount
Largest Size Container
,~ Days on Site
~oo
~oO
~cW
~c7V
3&:5'
<SAW
~
~~
&4-£.S '
Circle Which Months:
USE CODE
¡q
Pure [X] Mixrure [ ] Waste [
Rßdioactive [
8) STORAGE CODES
a) Container: ~ o~
b) Pressure; .01-
c) Temperature 0'/
~J. F, M, A, M, J, J, A, S, 0, N, D
9) MIXTURE: List
the t.iJre: most hazardous
chemic.1l components or
any ARM components
COlviPON'E;.i{r' CA.S# %WT ARM
I) P,€OPA -v c- . ' ; 7Q'98t;, '92... [ ]
2) , P.éoP,/¿..E/\/(;: .. .>' I IS 0 7 /. s [ J
J) AJ - tJ CfTrt N ~ Gæ. 'i;5C-t r~ NC" #fIKnt'<&: (00978 :3 [ ]
lO)LOCATION
N· ç C(>,eN~~ OF
P"'¿c,ß Fíf?í\¡
.
1) INVENTORY ST A IUS: New [ ] Addition [ ] Revision [.Xj Deletion [
2) Corrunon Name: Ac.e¡e' C.e-IV e-
Chemical Name: A-cG'r'2;:--z...e-,lVe
'-I) Physical & Health
P..azard Categories
Check if chemical is a NON Trade Secret [C(] Trade Secret [
3) DOT Ii (optional)
AHM [ ] CAB #
7 'I~ 8io-Z-
PHYSICAL HEAL rn
Fire [Xl Reactive [ ] Sudden Release of Pressure (){'] Immediate Health (Acute) [ ] Delayed Health (Chronic) [
5) WASTE ClASSIF1CATION
(3-digit cOOe from DF..5 Form 8022)
USE CODE
'3 L/Cj I
6) PHYSICAL STATE
Liquid [
Gas C-(]
Pure [ Xl Mixture [ j Waste [
Rßdioact:ive [
Solid [
ï) ,'lu.'vfOUNT AJ.'ID TIME AT FACILITY
~faximum Daily Amount I t;co FrJ
A verage Daily Amount I CD A3
Annual Amount ! V1!7 PI'>;;
LMgest Size Container I Cb FT3
# Days on Site 3 ts;.S'
l.JÑTIS OF MEASURE
LOO [ ] Gal [ ] ft3 rX1
Curies [ ]
Circle Which Months:
9) MIX1ù"RE: List
the thr~ most hazardous 1 )
chemical components or 2)
any ,A.ffiv{ components 3)
COMPONENT
/J c e ît::'l...C.. 'V' e
8) STORAGE CODES
a)Conuliner. ~
b) Pressure: é;;l.
c) Temperature D '1
@J, F, M, A., M, J, J, .-'\, S, 0, N, D
CA.S# % m
7 'i~{ç2. I r::;t;) &:13
ARM
[ ]
[ ]
[ ]
iO)LOCATION
5· S>iJe CP ~ S;-~~rð (N i?rrc¡é
r certify under penalty of law, that I have personally exanrined and am familiar '.vith the inlòrmation on this and all attached dccume:nts.
'<lieve the >ubminod infonnation ~ <rue, ="",tè ",d compiete. #
iJ/'J-vrò (...~ < (fA--~YS - rIt,4/V4{;,(?/¿ , ~/ ø' I /¡¿/«?-f'
?RlNr Nome & rid, of Aothorized Company R""""",IBù" SigMrur~ Dote
'.
~ ff '..
- ,
IzARDOUS MATERIALS INVEN-IRY
1
Business Name
(\jPffC e?
Page_of_
Address èZ!YO S, U AJ r r:/ A:J Av e Ó4¡{M!SF-I ~-z.D. c;4. 9336)
CHEMICAL DESCRIPTION
2) Common Name: ðxy GE:r'/
l) rNVENTORY STATUS: New [ ] Addition [ ] Revision [ J Deletion [ ] Cheà if chemical is a NON Trade Secret [ Trade Secret [ J
3) OOT # (optional)
Chemical Name:
o xi 6-DY
ARM [ ] CAS #
77)ÿL- r.¡c.¡-7
4) Physical & Health
Hazard Categories
Ph"YSICAL HEALTH
Fire [ ] Reactive [ J Sudden Release of Pressure [XJ Immediate Health (Acute) [ ] Delayed Health (Chronic) (
5) WASTE ClASSIFICATION
6) PHYSICAL STATE
Solid [
Liquid [
7) Ai\10UNT AND TIME AT F ACILIIY
Maximum DWy Amount j'l'1 '1 J:::!:3.
A verage Daily Àmount / 'f~<f FíJ
Annual Amount 2 tF7 Pr3
Largest Size Container z. 'f 1 Fr 3
# Days on Site '3 0S
9) MIXTURE: :uList
the three most hazardous 1 )
chemical rompon~ts Of' 2)
any ARM romponents 3)
(3~git code from DfIS Fonn 8022)
USE CODE
3'fo/J
Gas [X]
Pure [)é] Mixture [ J Waste [
Radioactive [
UNITS OF MEASURE
LOO ( J Gal [ ] ft3 [X]
Curies [ ]
Circle Which Months:
8) STORAGE CODES
a) Container: ~ 0 <¡
b) Pressure: 0 z,
c) Temperature ð'l
~}, F, M, A, M, J, J, A, S, 0, N, D
CN3# ,_ % WI
77r?¿t:¡q7 "J?~
ARM
[ J
[ J
[ J
COMPONENT
o><:y&eJ'{
IO)LOCATION
S· sIDe
OF 5 FfP~ t'.N
/!A-CK
¡) IN'/ENTORY STATUS: New [ ] Addition [ ] Revision [)J Deletion [ Check if chemical is a NON Trade Secret [-X1 Trade Secret [
2) Common Name: A-£&O-v
3) OOT ;; (optional)
Chemical Name: ,Æ-"eC--G",v
ARM [ ] CAS;;
7 ¥ 7'D -3 7 - I
4) Physical & Health
Hazard Categories
PHYSICAL HEALTH
Fire [ ] Reactive [ ] Sudden Release of Pressure [){J Immediate Health (Acute) [ ] Delayed Health (Chronic) [
5) WASTE CLASSIFICATION
6) Ph"YSICAL STATE
Solid [
Liquid [
7) Ai\1OlJNT AND TIME AT FACILITY
Maximum Daily Amount þC;r:; FJ:'..
A verage Daily Amount72u;- Fn
Annual Amount 7 ¿;,¿ F'D
Largest Size Container 7 ,,'- Pr3
II Days on Site '3 &:)
9) M1XTURE: List
the three most hazardous 1 )
chemical components or 2 )
any ARM romponents 3)
(3~git cOO.e from DHS Form 8022)
;3 '/'1/
USE CODE
Gas [X]
Pure LX] Mixture [ ] Waste [
Radioactive [
UNITS OF MEASURE
LOO [ ] Gal [ ] ft3 CX]
Curies [ ]
Circle \Vhich Months:
8) STORA.GE CODES
a) Container: 0 'i
b) Pressure: c <-
c ) Temperature Ð if
~ F, M, A, M, J, J, A, S, 0, N, D
CN3#
7'7'7e:;.31/
%WI
Ice
ARM:
( ]
[ ]
[ ]
COMPONENr
A'¿G-PH
I lO)LOCATION
I .>, s/.Þe !PF 5'rft?~ /AJ R"'fCK
! [ certiry under penalty of law, that r have personally examined and am familiar with the information on this and all attached documents,
I believe the submitted information is true, accurate and cmnplete.
,ù,f(/¡Ò {/J. ffrfGr-1 A/ J - /114/,./ #(,.e.-?
PRINT Name & Title of Authorized Company Representßtive
A6?ø ~~þq
Sj~ture
I //¿/ Cpr:!'
J /Date