HomeMy WebLinkAboutHAZ-BUSINESS PLAN
HAZARDOUS MATERIALS INVENTORY
CHEMICAL DESCRIPTION
_ CITY OF BAKERSFIfA)
8PFICE OF ENVIRONMENTA~ERVICES
1715 Chester Ave., CA 93301 (661) 326-3979
DNEW
DADO
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200
(one form per material per buitding or area)
Page of
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I. FACILITY INFORMATION
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BUSINESS NAME (Same as FACILITY NÃMÊorcfi3A:ÕõfiigBusfìiëSs'Ai,-""- -
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CHEMICAL LOCATION lÑ OfFIC.E Mb-f2..') ðfP~ t ~(u... ~ 201; g~~~llg:~~~J~~~)
FACILITY 10 #n:=Irffi1lCrr;-'T-r-;---1j MAP #(optional)---- -.-.-.--.-- --- --2õ3 --;-GRí5lf(oþ'tional) --
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,ç",_, II. CHEMIÇAL INFORMATION
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o Yes 0 No 202
204
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o Yes 0 No 206 :
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205
TRADE SECRET
I CHEMICAL NAME
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if Subject to EPCRA, refer to instructions
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- -207;--
EHS'
COMMON NAME
Dyes oNo 208
CAS #
209
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'If EHS_Ì!1'~~ all amounts'bclo1"'.,. ¡,è',h1~
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FIRE CODE HAZARD CLASSES (Complete if requested by local firechfêïj'---------------·---------------·---·- ----.
. --.--..--.-..--.-,--.
210
TYPE
o p PURE
~--------_.,-'--_._.,--_._--. ---.-.----------- ----
~MIXTURE 0 w WASï!: .<.';' R;.DIOACTIVE 0 Yes 0 No
-------~------f_- ._.--'-. ,---~ ---...,--.... -'--
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214 : LARGEST CONTAINER
212
CURIES
213
PHYSICAL STATE
o s SOUD
D I LIQUID
ÄGAS
-¿4
215
~-------_._._._~------_.__.._._-----_.._-_._-_... .
-----.- -.--- ...--
FED HAZARD CATEGORIES
(Check all that apply)
ANNUAL WASTE
AMOUNT
D 1 FIRE 0 2 REACTIVE ~RESSURE RELEASE 0 4 ACUTE HEALTH 0 5 CHRONIC HEALTH
- ~-,~,. --"",,,," -.-.-. ~) .¡;, ; -A,ÆRAG.·· . -. - -.-. '" I "ATIO WASTI' '"'"
____...:...':~~~~~~ ~ _._____~__~AI.:Y~~~N~_ _.__ ____.___ I
UNITS' 0 ga GAL CU FT 0 Ib LBS 0 tn TONS 221 II DAYS ON SITE
. If EHS, amount must be in Ibs,
-.-.-
216
220
222
STORAGE CONTAINER
(Check all that apply)
o a ABOVEGROUND TANK
Db UNDERGROUND TANK
DC TANK INSIDE BUILDING
o d STEEL DRUM
De PLASTlCINONMETALLlC DRUM
Of CAN
o g CARBOY
o h SILO
o i FIBER DRUM
OJ BAG
o k BOX
~ CYLINDER
o m GLASS BOTTLE
o n PLASTIC BOTTLE
o ò TOTE BIN
o p TANK WAGON
o q RAIL CAR
D r OTHER
2231
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2241
.------------.--- ..-.---.--.--. ._-..
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STORAGE PRESSURE
o a AMBIENT
¢..aa ABOVE AMBIENT
o ba BELOW AMBIENT
._-------.-.._-_._._~-----_. --.-- -- -...'
_.'-'- '.'. -~.-- --.-'--
STORAGE TEMPERATURE
J2h.AMBIENT
o aa ABOVE AMBIENT
;HAZARDOuàcÓMPÔ~E~JT
o ba BELOW AMBIENT
o c CRYOGENIC
225
I 0 Yes D No 22B I
-<-·---··--·---·--·1
231 I 0 Yes 0 No 232 I
- -------T----·--- --- -----.--,-
235 [ 0 Yes 0 No 236 I
,______-._"__m_____..______.__.___.._._._ ___.___ _.____ ...,,___. _", ..._________-1:-__. I
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.________________._____ ._______________ ___ .__~3~L~~~_ 0 No 240
____________________,_ 2431 0 Yes 0 No 244
,¡'~ ,!' . .....~ II,.; SIGNATURE .-,-- -- --,-,--.c________f}"j:m:~,;;;c':;>':~;'''-\':;~£ i(~'
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o COMPANY REPRESENTÃTIV~------SÎGNATDRE----"--·- -----------
EJ'fS'
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I 1 226
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2 230
I 3 234
4 238
5 242
229
_____....'_4__.__·_________·__·___··_·_ _+ _"._.'.___'__
233
_._-~._-----_._-----------_._.__. ..~'-._---'--'
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237
241
245
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UPCF (7/99)
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