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RIGDEN FARM, 8TH FILING, LOT 5, GREASE MONKEY/CARWASH - FDP - 56-98AK - SUBMITTAL DOCUMENTS - ROUND 1 - HAZMATS
CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31. SARA FORM ti 002 Rev. 11-94 FACILITY NAME: rnmase#qq ber or Address): g O S. 114 CHEMICAL DE CRIPTION INVENTORY AMOUNTS v STORAGE INFORMATION Read ALL Instructions before completing form MAX. AVG. I, c Z (Non -Confidential) L � . CAS NUMBER: Y1S LiC ON ON SITE SITE 3 o U 1- A:rp1 e 8I Storage Locations � - — — — PRODUCTOR n K�2VOSo� Pounds L` (LABEL)NAME:.Ye n Cu.F1.STP /9Culo-, _ PHYSICAL COP OSITION HEALTH HAZARD C'11 :k re ❑ ❑ ❑ 91 ❑ Imn o(hale (eeule) 1EIDelayed(chradc) Gallons it -la +r: Solid Liquid Gas Pure Mix (use actual quurnulae) TI T v PAO vfrolt Dig ECT10H Is this product or any of Its Ingredients on the SARA PEAK INVENTORY Statement about how this chemical Is used: Extremely Hazardous Substance (EHS) list? ❑YES ©N O MONTH(S) 1 3 4 5 2 8 II "YES" Its( EHS Name: 11 "NO" Is the chemical stored In Q i12 1.1„ 1u"r, amounts greator ❑ YES TRI NO I than 10.0001bs? El (Circle all that Apply) HAZARD CLASSES Aerosol Products TYPE OF HAZARD(S) FLAMMABLE/COMBUSTIBI E 110 11DS CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: L 0/ IQ. Percent of Mixture: 5 70 /e ❑ Blasting Agent ❑ Class 1A Flash [] Class 11 Ingredient Name: {or(�ss f`ni�oD �nrrtk ,� 1 ❑ ❑ El Carcinogen Corrosive pH Cryogenic Class 1B Point Class IIIA Class 1C /moo H ClasslllB CAS Number: e�r:� .8kA_'X-' U- — — — — Percent of Mixlureao-ds % �V' ❑Explosive LIQUIFIED PETROLEUM CAS (P Lp_GASj ❑ Flammable_Solld—Gas ❑ LPG In BLDGS -not accessible to public Ingledlenl Name: ❑ Hazardous Waste ❑ LPG In BLDGS-accussiblo to the public ❑ ❑ HlghlyToxic Infectious Agents In 1-1-Bcontalners 8 LPG In public assembly buildings. AS Number: - Percent of Mixture:-b % a Irritants LPG at conslnlCUon sties. ❑LPG outside IngredlentName: Q: IQfy0tI ot-) t"p(- ❑ El ❑ Non -Hazardous Chemical Organic Peroxide Other Health Hazard N.F. P.A.704 HAZARD RATING NOTE: Place 04 Flammability CAS Number: — — — Percent of Mixture: �-10 % ❑ Oxidizer neakiy J ❑ Pesticide In box Ingredient Name:-. �ici0i0.rl�C ❑ Pyrophoric Health Reacllvlly ❑ ❑ Radioactive Sensitizer — CAS Number: - — — — — — — — — Percent of Mixture: % ❑ Toxic ❑ Unstable (Reactive) Specl0l liazards Ingredient Name: ❑ Waler-Reaellve -vi" OX COR RAO (Circle all that Apply) Ills Unemlcel Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Retorting Form and IIIa Uniform Fire Code. Page Z Of L s CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: se nb, CHEMICAL DESCRIPTION Read ALL lnatructlons before completing form CAS NUMBER: PRODUCT OR LABEL) NAME: PHYSICAL COMPOSITION Ctwk ar ❑ W ❑ ❑ Irw1aF'Yhr: Solid Liquid Gas Pure Mix q y BLDG (Number or Address) INVENTORY AMOUNTS MAX. AVG. c ON ON J� SI(E SITE U I a` Pounds Ic I CU.FLS HEALTH HAZARD � 5 `_[0 ® Inro vdialo (ec:ule) "�'�'Ll_ —� Gallons Delayed (chroNc) (use actual quanllllea) Is this product or any of Its Ingredients on the SARA Exhomoly Hazardous Substance (EHS) list? ❑ YE S II "YES" list EHS Name: It "NO" Is the chemical stored In amounts greater f than 10,000 lbs7 ll ES ®N CIiEMICAL INGREDIENTS: TRADE SECRET: CAS Number: `Q- 7-- — — - a ( 1 Percent of MiXlure:� 9�i '/, IngredientName:t±by I2,y1-Q- uyCo� CAS Number: — — — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: - — — — — — — — — Percent of Mixture: IngredlentName: CAS Number: — — — -- — — — — — Percent of Mixture: % Ingredianl Name: CAS Number: IngredlentName: PEAKINVENTORY MONTH(S) 1 2 3 4 5 6 7 6 9 10 11 12 SARA FORM # 002 Rev. 11-94 9aW S.+kII)t STORAGE INFORMATION (Non-Conlidenllat) Storage Locations Statement about nho�w- thischemicalIs used: �Ij r 71 1 h 1� PE OF H FLAMMABLE/COM13(1STII3LE LIQUIDS• [] Class 1A Flash E] Class II gClass 1 B Point Class IIIA Class 1C c3U(v (H Class 11113 LIQUIFIED PETROLEUM GAS (I PC I PI P S1�AS1 ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB containers eLPG In public assembly buildings. LPG al construction sites. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place o a Flammability navfmj uh box Health L 9 Reactivity Special Hazards -W- Ox COR RAD 4 ❑ Water -Reactive (Circle all HIM Apply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Reporting Form and the Uniform Fire Code. Page Of I Percent of Mixture: e/u HAZARD CLASSES ❑ Aerosol Products ❑ Blasting Agent CJ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable —Solid —Gas ❑ Hazardous Waste ❑ HIghlyToxlc ❑ Infectious Agents P Irritants ❑ Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorle ❑ Radioactive Q) Sensitizer �j Toxic ❑ Unstable (Reactive) CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, SARA FORM p 002 Rev. 11-94 FACILITY NAME: &Mse Mor)bf,,�4-4c( y BLDG (Number or Address): 34(o0 sw.:t h v 11 CHEMICAL DESCRIPTION INVENTORY AMOUNTS STORAGE INFORMATION Read ALL Instructions before conlpletlnp form MAX. AVG. c (Non-Conlldential) CAS NUMBER:�` ON ON SITE SITEE Storage Locations F a r > PRODUCT OR c �j rnC( P5o � Pounds /� I I_ hrou✓d L21Aj (LABEL) NAME: t� 1 r YICi f 1Ut1k `r-+1� Cu.FLSTP PHYSICAL COMPOSITION Chock aM ❑ 0 ❑ ❑ 11..I-10y: Solid Liquid Gas Pure Mix Is this product or any of Its Ingredients on the SARA Exlrernely I lazardous Substance (EHS) list? II "YES" IIs1 EHS Name: II "NO" Is Ills chemical stored In amounts greater than 10,000lbs? ® luYiwdialo(ecula) r�Gallons I-1 Delayed (chroNc) (use actual quanlllles) I❑YES bd NOII ES ©NO CliEMICAL INGREDIENTS: TRADE SECRET. CAS Number: ___d to '41 —4 a — SR sZL - O Percent of Mixture: Ililgradieni Narne: CAS Number: _ — — — — _ _ — — Percent of Mixture: % Ingredlent Name: CAS Number: Percent of Mixture: % Ingredient Name: ICAS Number: Percent of Mixture: % I Ingredient Name: ICAS Number: Percent of Mixture: % Ingredient Name: PEAKINVENTORY MONTH(S) 1 2 3 4 5 7 8 9 10 11 ON (Circle all that Apply) Statement about how this chemical Is used: HAZARD CLASM ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pFl ❑ Cryogenic ❑ Explosive ❑ Flammable_ Solid_ Gas 1A liazardous Waste ❑ 1-ilghly Toxlc M Infectious Adonis IQ' Irritant's lid Non-hlazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide 0 Pyrophoric ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) (7 Water -Reactive FLAMMABL E1COMBUSTIBLE LIQUIDS: ❑ Class I Flush ❑ Class II Class 1 B Point Class IIIA Class 10 airL Class IIIB LIQUIFIED PETRQI.E 1M GAS (LPG. LP-GASI ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB coniainers ❑ LPG In public assembly buildings. ❑ LPG at construction sites. ❑ LPG outside N.F.P.A.704 HAZARD RATING NOTE: Place0.4 Flanunablllly nato �J in Lv-v I. Health p Reactivity Speclal -lazards —W- OX COR RAD (Circle all that Apply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Reporting Form and the Uniform Fire Code. Page �_ Of I. CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: CHEMICAL DESCMPTION Read ALL instructions before completlnp form CAS NUMBER: PnODUCT OR M.�,1�., 1 .�1�, _ p,., (I ABEL.) NAME: Mdai J� I l? P T 1J 1% PHYSICAL COr1POSITION clWor as ❑ 0 ❑ ❑ 11.1a 1. Solid Liquid Gas Pure Mix Is It11s product or any of Its ingredients on the SARA Extremely Hazardous Substance (EHS) list? BLDG (Number or Address): INVENTORY AMOUNTS MAX. AVG. c ON ON SITE SIZE F Pounds CU.FI.STP I ff_� l n nadiale (ecate) � r� 0 100 Gallons Delayed (chronic) (use actual quanllllea) YES II "YES' Ilsl EHS Name: If " NO" Is 1110 chemical slored In amounts greater Illan 10.000ibs? ❑ YES CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number. -- — — — — — — — — Percent of Mixture: Ingredient Narne: AS Num PEAK INVENTORY NO MONTH(S) 1 2 3 4 5 7 8 9 10 11 N O ALL ONTH rc - — — — — — — — — Percent of Mixture: % Ingredlent Name: ----- CAS Number: Percent of Mixture: 0/1 Ingredient Name: CAS Number: - — — — — — — — — Percent of Mixture: % Ingredlent Name: CAS Number; mu bor:r Percent of Mixture: % IngtodlenlName: SARA FORM / 002 Rev. 11.94 1 ?'a,(z0 SCt i-(-, H_Dl I STORAGE INFORMATION (Non -Confidential) &I Storage Locations Statement about flow this chemical Is used: HAZARD CLASSES ❑ Aerosol Products ❑ Blasting Agent C7 Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable_Solld_Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infeclldu,§ Agents Irrllanls Non -Hazardous Chemical Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ PyrophorIc 1] Radioactive L7 Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive OF FLAMMABLE/COMB ►STIBLE LIO LIDS: [) Class 1A Flash [] Class II Class 18 Point Class ILIA Class IC I 8 Class IIIB 1,10I)IFIEQUIROLFUM r,As (LPG I. P-GASI ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1•LBconlainers ❑ LPG In public assembly buildings. ❑ LPG at construction sites. ❑ LPG oulslde N.F.P.A.704 HAZARD RATING NOTE: Nlxa o a Flammability nanny �� In w,r Health C) I O Reactivity Speclal Hazards -W- OX COR HAD (Circle all II al A I 1 pp Y) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title 111, Tier 11 Reporting Form and the Uniform Fire Code. Page / Of CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: n Oy1 fi BLDG (Number or Address): ` CHEMICAL DESCRIPTION INVENTORY AMOUNTS Read ALL Instructions before completing form MAX.NA ON N � ro ON !� � E ��� � �" SITE SITE" CAS NUMBER: Ll- I a� leJ� 9, _ — — _ — 3 r a.. IT PRODUCT OR LABEL) NAME: PHYSICAL COMPOSITION El B uwlawfy: Solid Liquid Gas Pure Mix Is this product or any of its Ingredients on the SARA Ealrennaly Hazardous Substance (EHS) Lis(? II "YES" list EHS Name: II "NO" Is 1110 chemical stored In amounts greater r Ihun 10,0001bs? L Pounds CU.FLSTP ILTH HAZARD /O In°Wd+aw (aculu) Gallons D°lay°d (ch(anlc) (USa actual quantllles) 6111M L CHEMICAL INGREDIENTS: TRADE SECRET: L—� CAS Number: '/ clicWp I -k -2 - - - 19 - 'L Percent of Mixture: f % nc��' on IngredientName:_a1i C A('.I:d , DI Lri-Y &c , CAS Number: - - - - - - - - - Percent of Mixture: Ingredient Name: CAS Number: - - - - - - - - - - Percent of Mixture: % hlgredient Name: CAS Number: - - - - - - - - - Percent of Mixture: Ingredient Name: CAS Number: - - - - - - - - - Percent of Mixture: Ingredient Name: PEAKINVENTORY MONTH(S) 1 2 3 4 5 E 7 e 4 in 11,112 (Circle all that APP10 SARA FORM M 002 Rev, 11-94 STORAGE INF RMATION (Non-Conlldenllal) Storage Locations Statement about flow this chemical Is used: TYPE HAZARA CLASSES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flamlriable_Solid_,Gas ❑ Hazardous Waste ❑ HlghlyToxlc ❑ Inlecilods Agents ,P Irritants 9 Non -Hazardous Chemlcal ❑ Orgaillc Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide 0 Pyrophorlc 17 Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Waler-Reactive FLAMMABLE/ .OMB ISTIBI IF I InIli ; ❑ Class 1A Flesh Class II BClass 1B Point Class IIIA Classic A3— 8 Class IIIB L IOUIFIED PETRO EU ,AS rLp_G, Lp-GAS ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB containers ❑ LPG In public assembly buildings. ❑ LPG al construcllon sites. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Piwao,l Flammability Ralklu ",.J in wx Health ' (� Q Reacllvlly Special Hazards -w- OX COR RAD (Circle all that A I ) IPy This Chemical Inventory Report Form meals the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form and the Uniform Fire Code. Page L Of I CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, Iggg FACILITY NAME: fPASe Mon * LDG (Number or Address): CHEMICAL DES&hIPTION INVENTORY AMOUNTS Read ALL Instructions before completing form MAX. AVG, c �' ON Oil lyu� CASNUM LYE KA� SITE SIfE PRODUCT OR I.ADEL) NAME: PHYSICAL COMPOSITION cn� x au ❑ W El El Owwmy: Solid Liquid Gas Pure Mix Pounds CU.FI.S 9LTH HAZARD ID Imrrwutials (acute) Gallons Delayad (cluoNc) (use nclual quantlaes) Is this product or any of its Ingredients on the SARA Extremely Hazardous Substance (EHS) list? ❑ YE S II "YES" list EHS Name: If "NO" Is Ills chemical slored In amounts greater than 10,000lbs? 11 PEAKINVENTOR NQ MONTH(S) 1 2 3 4 5 7 B _ 9 10 11 YES MN CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: Lz 4 � -0 1 — - J a - 3 Percent of Mixture, edl, Ingredlent Name: CAS Number: i..,3LQ—---Se5-� Ingredient Name: Percent of Mixture: 10 % CAS Number: a- Q — — Z Z 1 Percent of Mixture: �_% Ingredient Name: U+hi,A Y--n S oO.,Q Ni C KP qo y- CAS Number: `Q y P--a 1L Ingredient Name: JAR KQnecA t O jr CAS Number: �$z$3---3u � Percent of Mixture: -3 % L ner�P 4Hv t &tc Percent of Mixture: 1, r Ingredient Name: t-co ( �-{6cjs lUo-Z2.1.liv,, L SARA FORM 111002 Rev. 11-94 STORAGE INF RMATION (Non•Conlldenllal) Storage Locations Y Statement about how this chemical Is used: 6 12 HAZARD CLASSES ❑ Aerosol Products ❑ Blasling Agent la Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable —Solid _Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents ❑ Irritants O Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other lieallh Hazard ❑ Oxidizer 11 Pesticide ❑ Pyrophorlc O Radioactive ❑ Sensitizer ❑ Toxic O Unstable (Reactive) ❑ Water-Reactive H FLAMMABLE/COMB ISTIBLE I (QI11D^• ❑ Class 1A Flesh ❑ Class 11 Class 8 I Point H Class IIIA Class iC Q5L� Class IIIB L IOLIIFIEb P�TRO _ 16! (yAR ( PG, l•p_ A ) ❑ LPG In BLDGS -not accessible to public ❑ LPG Ili BLDGS -accessible to the public In 1-1-Bcontalnefs LPG In public assembly buildings. LPG at consinlcllon sites. ❑ LPG outside N.F.P.A.704 HAZARD RATING NOTE: Praceo-4 Flammability Baling J in tx* \ Ho.allh L Reactivity Special hlazards -W- OX COR RAD (Circle all Ihal Apply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form and the Uniform Fire Code. Page --I Of CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, _ qq_ SARA FORM N 002 Rev. 11-94 FACILITY NAME:LMS-eMMN� IHAq BLDG (Number or Address): $a(00 S . o 11 CHEMICAL DESCRIPTION INVENTORY ar STORAGE INF RMATION Read ALL Instructions before complellnn form MAX. AVG. c v '�° (Non-Conlidentlai) CAS NUMBER: 9�[l_I— - — — — ON ON SITE SITE o I E U 1- n. 8 Storage Locations PRODl1CT OR ( Pounds L E (I ADEL) NAME: - F— e� Cu. FLSTP PHYSICAL COMPOSITION Ctl :A am ❑ ® ❑ ❑ ® HEALTH HAZARD Immadiale (acula) 15 Gallons rrbr+vWy: Solid Liquid Gas Pure Mix Delayed(chrodc) (use actual quanllltes) ❑r:;:. 71 V --------.- T V P P CTIO " Is this product or any of Its ingredients on the SARA �+ PEAK INVENTORY Statement about how this chernlcal Is used: Extremoly Hazardous Substance (EHS) list? ❑YES (ZN O MONTH(S) II "YES' list EHS Name: 1 7 2 3 4 5 6 8 9 0 11 12 A1_ L 11 "NO" Is the chemical stored in amounts greater ❑ YES N O LL MONTHS than 10.000 lbs9 ❑ (Clrc a all that Apply) HAZARD CLASSES Aerosol Products TYPE OF HAZARD(S) FLAMMABLEIMMBLISTIBLE LIQUIDS CHEMICAL INGREDIENTS: TRADE SECRET: C� CAS Number: —T— 4 - Percent of Mixture: (O % ❑ Blasting Agent [I Class 1A Flush ❑ Class II IngredlenlName F ClSnc� ��� m 11N�1 t O ❑ Carcinogen Class 1B Point (� Class IIIA H fi " -+ ❑ ❑ Corrosive pH Cryogenic Class 1C A)M ❑ Class IIIB CAS Number. C) L �[ I 14 -& � L — L le -a Percent of Mixture: 5 % ❑ Explosive EU l IOUIFIED PETROLEUM 1M CAS (I.PG. L P SAS► ❑ Flammable [] In ©LOGS -not accessible to public r� Ingredient Name: ❑ Hazardous Waste —Gas ❑ LPG In BLDGS -accessible to the public El Highly Toxic in 1-t-B containers ❑ LPG In public assembly buildings. CAS Number. — — — — — _ — — — Percent of Mixture: `fie El �I lAgents Irritants [J LPG al construction sites. ❑ LPG outside IngredlenlName:_ El ❑ Non -Hazardous Chemical Organic Peroxide Other Health Hazard N.F. P.A.704 HAZARD RATING NOTE: Praca0.1 Flammability CAS Number: -- — — — — — — — — Percent of Mixture: % ❑ Oxidizer narury ❑ Pesticide in Wx O Ingredient Name: ❑ Pyrophorlc Ilealih a o Reactivity ❑ ❑ Radioactive Sensitizer CAS Number: - — — — — — — — — Percent of Mixture: % ❑ Toxic ❑ Unstable (Reactive) Special Hazards Ingredient Name: ❑ Water-Reaclive OX COR RAD (Circle all that Apply) I nis u nemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title 111, Tier 11 Reporting Form and the Uniform Fire Code. Page / Of CHEMICAL INVENTORV RFPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, SARA FORM t+002 Rev. 1144 FACILITY NAME: (QpSe k BLDG (Number or.Address): CHEMICAL DES16RIPTION INVENTORY AMOUNTS v STORAGE INFORMATION Road ALL Instructions before completing form MAX. A AVG. v (Non-Conlldenllai) CAS NUMBER: rn jr( _ ON SITE SITE �. E 3 r 6. 12 Sl Storage Locations � _ — — — — Pounds L 6-rciuid (. -L e PRODUCT OR j� (LA8EL)NAME: LC' 10 1.1P(XL ( d ountf) Cu.FI.STP � �5_ Gallons — PHYSICAL COMPOSITION chwk aY ❑ ® ❑ ❑ HEALTH HAZARD ImJifll rrWo (aculu) uWrakvv: Solid Liquid Gas Pure MIX ® Dalayod(chrordc) (use actual quan111lea) ri v T P P C l0' Is this product or any of Its Ingredients on the SARA PEAK INVENTORY Statement about how this chemical Is used: ExlremelyHazardous S(Ibslance(EHS)list? LEI YES K. NO MONTH(S) II `YES" IIs1 EMS Name: 1 7 2 3 4 5 6 8 9 11 12 fir./n�PlX1111. - Mi�nr�Ifcl�7r� /Ybitii r 11 "NO" Is the chemical stored In amounts greater Than 10.000 Ibs? ❑ YES N O (Circle all that Apply) CHEMICAL INGREDIENTS: TRADE SECRET: C� ❑ HAZARD CLASSES TYPE OF HAZARD(S) CAS Number: 1-0 J ? — Percent of Mixture: 32- 0% Aerosol Products FLAMMABLE/COMBUSTIBLE LIQUIDS- 0 Blasting Agent E] Class 1A Flash I] Class II IngredlenlName:LQ I. SO ve-, -- ❑ ❑ ❑ Carcinogen Corrosive pH Cryogenic Class 1B Point Class IIIA 8 Class 1C Class IIIB me+trod Used : node bebw i(oo F CAS Number: Q 1 ° Percent of Mixture: 5 /° ❑Explosive LIQUIFIED PETROLEUM G > AS (LPG. PC I p. AS► ❑ Flammable_ Solid ❑ LPG In BLDGS -not accessible to public Ingredient Name: >°ho _r�i � ❑Hazardous Waste —Gas ❑ LPG In BLDGS -accessible to the public _�41r10 11Highly ❑ Toxic Infectious Agents In 1•LB containers LPG In public assembly bulldingS. H CAS Number: — — — — — — — — — Percent of Mixture: % Ca IrrltantS LPG at conslrucllon sites. [I LPG outside Ingredient Name: Non -Hazardous Chemical ❑ ❑ Organic Peroxide Other Health Hazard N.F.P.A.704 HAZARD RATING NOTE: Place o-4 Flamnlabillly CAS Number: — — — — — — — — — Percent of Mixture: % ❑ Oxidizer nar6ry '-1J ❑ Pesticide 'nWK Q Ingredient Name: ❑ Pyrophorlc Health Q Q Reactivity ❑ Radioactive CAS Number: 11 Sensitizer - — -- — — — _ — — Percent of Mixture: % ❑ Toxic Ingredient Name: ❑ Unstable (Reactive) Special Hazards —w OX COR RAD ❑ Water -Reactive (Circle all that Apply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier 11 Reporling Form and the Uniform Fire Code. Page Of i CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, SARA FORM p 002 Rev. 11-e4 FACILITY NAME: --cgltst m BLDG (Number or Address): CHEMICAL DESCRIPTION INVENTORY AMOUNTS aa STORAG INFORMATION Reed ALL Instructions before completing farm MAX. AVG. ON ON �' �, (Non•Conlidenllal) CAS NUMBER: mL L(�1����. SITE SITE iDUi r a` r Storage Locations M _ _ _ Pounds L�nmrenr� �L`Pl PRODUCT OR GG ' _CJ qJ K�1 (LABEL) NAME: vte✓ Cu.F1.9TP PHYSICAL COMPOSITION Cndct AN ❑ P],J ❑ ❑ HEALTH HAZARD 11MImmediate (aculd) ��(� I� `• 0 L5 Gallons _ it-ia y: Solid Liquid Gas Pure Mix Delayed(chicrilc) (use actual quwtlltlee) :::::: ;7 - T- Y P pvolt plpEcyI0Hp'ET. Is this product or any of Its Ingredients on the SARA PEAK INVENTORY Statement about how this chemical Is used: Extremely Hazardous Substance (EHS) list? YES NO MONTH(S) 2 3 4 6 73rtm If "YES' Iisl EHS Name: 7 1 - llnejAnffa ig fAt: It `NO" Is the chemical stored In amounts greater ❑ YES NO MONTH than 1D.000lbs7 (Girdsail ha P y) CHEMICAL INGREDIENTS: TRADE SECRET: ❑ HAZARD CLASSU Aerosol Products TYPE OF HAZARD(S) FLAMMA®LE/GOMBLISTIBtE LIQI)IDS CAS Number: 3 � S g _ Percent Mixture: _Q _ of _% ❑ Blasting Agent ❑ Class 1A . Flash (] Class II IngredienlName:>r.�� hvl F+I�,e� " T �g F ❑ ❑ Li ❑Explosive Carcinogen Corrosive pH Cryogenic Class Point Class IIIA g Class iC �7 I� 1 H Class IIIB LIQUIFIED PETROLEUM GAS ((P I P- ASI CAS Number: — .� .7 - 1 Percent of Mixture: r�% Ingredient Name: � �u - p�� �i-�'1P.r ❑ ❑Hazardous Flalninable—Solid Waste _Gas ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public � El ❑ HighlyToxic Ilectlous Agents 1111 •LBconlalnars LPG In public assembly buildings. 8 LPG al construction sites. CAS Number: Percent of Mixture: % En Irritants ❑ LPG outside hlgredlentName:�.��g�nc) ;,.,,, I(1tY�'lr►P, 9 Non -Hazardous Chemical ❑ Organic Peroxide Other Health Hazard N.F.P.A.704 HAZARD RATING NOTE: Plata d•a Flammability CAS Number: Te �101C•e � Percent of Mixture: % ❑ Oxidizer narrow J ❑ Pesticide in1 x Ingredient Name: ❑ Pyrophoric Health L Q Reactivity ❑ Radioactive CAS Number: ❑ Sensitizer Percent of Mixture: % ❑ Toxic ❑ Unstable (Reactive) Special Hazards . IngredienlName: ❑ Water-Reacllve -W' OX COR RAD (Circle all that Apply) Title Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier If Reporting Form and the Uniform Fire Code. Page -I-- Of 1 CHEMICAL INVENTORY REPORT T REPORTING PERIOD From: JAN. 1, to: DEC. 31, SARA FORM N 002 Rev, 11.84 FACILITY NAME: $ 1 BLDG (Number or Address): 8d(p0 S • I � 1 CHEMICAL DESC PTION INVENTORY AMOUNTS v STORAGEINFORMATION Read ALL Instructions before completing form MAX. AVG. c d (Non-Conlidenllal) CAS NUMBER: L . ON ON l'f siTE SITE E 12 Storage Locations � — — _ PRODUCT OR (� (1 ABEL) NAME: .�,( U ME ZP0 (� , �'^ e Y 11 A C � ,?C k r1P_(� Pounds ,,,. ,-, „r„ �_ Gr as f a1r] L. LAa -- PHYSICAL COMPOSITION — HEALTH HAZARD Chuck ak El El El� R] hranad ato (acute) ilwr+rwN: Solid Llquld Gas Pure Mix Delayod(chronlc) Is this product or any of Its Ingredients on the SARA ExIrernely Hazardous Substance (EHS) list? ❑ YES ®N O II `YES" Ilst EHS Name: II "NO" Is Ilia chenilcal stored In amounts greater YE S ®N O than 10,000lbs7 CHEMICAL INGREDIENTS: TRADE SECRET: C� CAS Number: — — 2 - 5- Percent of Mixture: 3o-qo% Ingradiant Name: _ LI nnnnen ICAS Number: — — — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: — — — — — _ — — — Percent of Mixture: % Ingredient Name: CAS Number: -• — — — — — — — — Percent of Mixture: % IngredlenlName: CAS Number: — — — — — — — — — Percent of Mixture: % nl Name: (use actual quanallos) PEAK INVENTORY MONTH(S) 1 2 3 4 5 6 7 11 12 (-BALL M MONTH Statement about how this chemical Is used: HAZARD CLASSES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable —Solid —Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents Irritants Non -Hazardous Chemical ❑ Organic Peroxide ❑ 01118( Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophoric ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water-Reactive OF FLAMMABLE/COMB 1STIBLIlQ )LIDS ❑ Class 1A Flash [] Class II j Class 1 B Point 8 Class IIIA 6 Class 1C � Class IIIB LIQUIFIED PETROLEUM GAS1LPG. L,P• GAS► ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS-aCCOSSIUla to the public In 1-LB conlalners ❑ LPG In public assembly buildings. ❑ LPG at construction silos. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Price oa Flammability nawty ,� arWx n Health D' Reactivity Special Hazards -W- OX COR RAD (Clrcle all that Apply) Ilia 1 IIVIIIlGal Inventory report Form meets the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form and the Uniform Fire Code. Page _,/ OF CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, Lc ftff sARA FORM a ooz Rev. 11 eq FACILITY NAME: sky BLDG (Number or Address): $ Z (pQ 5. CHEMICAL DESCRIPTION INVENTORY AMOUNTS STORAGE INFORMATION Reed ALL Instructions before completing form MAX. AVG. (NOn-COI111d0f111A1) S CAS NUMBER: YYLI . - - _ - ON ON SITE SITE 7� U F to -Storage Locations PRODUCT OR n , '�I\ zP a m ' ��3 (� t > Pounds $ .L S_1Q;;A Icd I pus. k (LABEL) NAME Cu.FI.STP Check ea 0 ® 0 0 0 ® Inunsv;alu(acute) 11WlaPr4y: Solid Liquid Gas Pure Mix ® naleyaa(chraNc) Is this product or any of Its Ingredients on the SARA _ Extremely Hazardous Substance (EHS) list? YES ❑. N O II "YES" list EHS Name: It "NO" Is Ilia chemical stored In amounts greater YE S �1 LD Illun 10,0001bs7 N O CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: Ue Percent of Mixture: IngredleniNainw C. No pyl %kA. CAS Number: - — — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: - — — — — — — — — Percent of Mixture: % Ingredient Name: CAS Number: - — — — — — — — — Percent of Mixture: % Ingredient Name: CAS Number: - — — — — — — — — Percent of Mixture: % Ingredient Name: 11L L 5 Gallons (use actual quantifies)_60099 PAGE Fog PIRECT1080 PEAK INVENTORY Statement about how this chemical Is used: MONTH(S) 1 2 3 4 5 8� 1.1 - l >•P Vl�' 7 1 12 ALL MONTH HAZARD CLASSES (Circle all Thal A ply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form and Ilia Uniform Fire Code. Page Of CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, _/998 SARA FORM N 002 Rev. 11-94 FACILITY NAME: $ BLDG (Number or Address): 9(3(oO S . INVENTORY AMOUNTS v STORAGE INFORMATION CHEMICAL DESCRIPTION Road ALL Instructions before completing form MAX. AVG. v (Non-Conlldenllal) ON CAS NUMBER:a. — — — — — — — — SITE sRe F E Storage Locations 5C) Pounds �rotu ,� ire PRODUCTOR a P,e �► aQ rari-�- (LABEL) NAME: : R-1 Cu. FI.STP — ChICk au ❑ ® ® ❑ ❑ 0 Invnedtals(acute) 11.1arr9y: Solid Liquid Gas Pure Mix ® Delayed(chiork) Is this product or any of Its Ingredients on the SARA Exlromeiy Hazardous Substance (EHS) list? ❑ YES ®N 0, II "YES" list ENS Name: 11 "NO" Is Ills chemical stored In amounts greater YE S �] N O than 10.000lbs? CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: Q 75 — — — — - � i lZ - Percent of Mixture: its % Ingredlenl Name: �h�Orod i-4- � 110�[�� P:1,—�r-n YIP . CAS Number: — — — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: — — — — — — — — — Percent of Mixture: Ingredlenl Name: CAS Number: — — — — — — — — — Percent of Mixture: ingredlonl Name: CAS Number: — — — — — — — — — Percent of Mixture: Ingredient Name: Gallons (use actual quanllllos) PEAK INVENTORY Statement about how this chemical Is used: MONTH(S) 7 8 3 4 5 2 A�t� Ifri= rpi>p>1Ic�4 il� i �t C-ALL MON TY HAZARD CLASSES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen Corrosive pH Cryogenic L] Explosive ❑ Flammable— Solid —Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents �1 Irritants ❑ Non -Hazardous Chemical El Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive 17 Sensitizer .® Toxic ❑ Unslable (Reactive) ❑ Water-Reacllve F_L.AMMABI E/COMB 1STIBI E IOIIine. ❑ Class 1A Flash ❑ Class II 8 Class 18 Point Class IIIA Class 1C nl/ 4 Class Ilia LIQUIFIED PETRO[ FUMGAS 1 P�p qSI ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to Iho public In 1-LB conlalnels 8 LPG In public assartlhly bulldings. LPG at construction lilies. ❑ LPG outside N.F.P.A.704 HAZARD RATING NOTE: Praca o 4 Flammability in baK �J o_ Health fl Reactivity Special I lazards —W OX COR RAD (Circle all that Apply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form and the Uniform Fire Code. Page 1— Of _L CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME:Q5e new { y BLDG (Number or Address): CHEMICAL DES IPTION INVENTORY AMOUNTS Read ALL Instructlons before completing form MAX. AVG. ON ON CAS NUMBER: SITE SITE PRODUCT OR Q`-�— — — — — — — l— — 50 Pounds L 3� 'LABEI) NAME• Qk(an 1 CU.FI.STP r:nack eu ❑ ® M ❑ 11vr+roi. Solid Liquid Gas Pure Mix Is this product or any of Its Ingredlenls on Ilia SARA Extremely Hazardous Substance (EHS) list? lawmctala (aculu) Gallons D°ley°d (chrorJc) (uso actual quanllllea) 1[]YES� NOII Il "YES" list EHS Name: If "NO" Is the chemical stored In amounts greater YES ®N O Ihan 10,000Ihs9 CHEMICAL INGREDIENTS: TRADE SECRET: AS Number: 1 — — — Z - 2 Percent of Mixture: Ingredient Name: l} ��t-�(QX1UOfOe_TAIClYle. CAS Number: - — — — — — — — — Percent of Mixture: % Ingredieni Narne: CAS Number.- - — — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: — — — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: — — — — — — — — — Percent of Mixture: % Ingredient Natne: SARA FORM M 002 Rev. 11-94 STORAGE INFORMATION (Non-Conlldentlal) Storage Locations PEAK INVENTORY Statement about how tills cinemlcal is used: MONTH(S) 1 2 3 4 5 8 ko 7 8 11 12 J&ALL M to — all that HAZARD CLASSES O Aerosol Products 17 Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable _ Solid —Gas ❑ Hazardous Waste ❑ Flighty Toxic ❑ Infectious Agents $l Irritants ❑ Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide L7 Pyrophoric fO Radioactive C] Sensitizer ❑ Toxic ❑ Unstable (Reactive) 11 Water -Reactive PE OF HAZARD(S) F_LAMMABI.E/COMB 1STIBl E 1IOt11Dg- [] Class 1A Flash [) Class II gClass 1 B Point Class IIIA Class IC n1//} 8 Class IIIB IIQLIIFIED PETRQI,e l���AS Il P�l P AS► ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 118 containers 8 LPG In public assembly buildings. LPG et conshuclion sites. ❑ LPG outside N.F.P.A.704 HAZARD RATING NOTE: PI°cso4 Flammability narury �J Gi Wx 0 Ilealth 'd U Reactivity Special Hazards -w- OX COR RAD (Clrcte all that Apply) This Chemical Inventory Report Form meets the reporting requirements of S,A.R.A. Till a III, Tier 11 Reporting Form and the Uniform Fire Code. Page -LOf -/ CHEMICAL INVENTORY REPORT I REPORTING PERIOD From: JAN. 1, to: DEC. 31,— f SARA FORM t<oo2 Rev. 11-94 _. FACILITY NAME: bmse. ( ( pn *qH 113LDG (Number or Address): ga (pO SC1,Ctf, .611 CHEMICALbESCRIPTION INVENTORY AMOUNTS a STORAGE INFORMATION MAX. AVG. (Non Cor111dentlal) Read ALL Instructions before completing term ON ON CAS NUMBER: (� 7 \ sll'E slrE Storage Locations '�^A CC11 __ Pounds 1 1 Gror,r.rxJ (ntx.ep (LABEL) NAME: + trl0 \� �r fi51ll P`� 1A li 7�l — Cu.F1.STP Cha ka4 ❑ ® ❑ ❑ ® ® Imrnodialo(aculo) � 2 Gallons 0-(A"ar: Solid Liquid Gas Pure MIX Dalayad(chroric) (use actual quentlllas) Is !his product or any of Its Ingradlenls on the SARA PEAK INVENTORY ExIremelyHazardous Substance (EHS)list? YES ❑ NO MONTH(S) 1 2 3 4 5 6 1YES" list EHS Name: 7 I nN&i IS ,12 It "NO" O" Is Ilse chemical stored In amounts greater than 10,000 Ibs? ❑YES N O(Circle all that Apply) CHEMICAL INGREDIENTS: TRADE SECRET. CAS Number: (0 :7- — — — — - -rJ 4 - 1 Percent of Mixture: q_°/a IngredlentName:K�IDIQA� cl rn I I-- — — — — — — — — Percent of Mixture: % Ingredient Name: CAS Number: - — — — — — — — — Percent of Mixture: Ingredient Name: — CAS Number: -- — — — — — — — Percent of Mixture: Ingredient Name: CAS Number: Percent of Mixture: Ingredient Name: T Statement about how this chemical Is used: �7h1" , I' u• TYPE OF HAZARD(S) HAZARD CLASSES ❑ Aerosol Products I-E/COMB 1STIB E LIQUIDS; ❑ Blasting Agent [) Class 1A Flash Class 11 ❑ Carcinogen Class1B Point Class111A 8 ❑ Corrosive pH Class 1C 6, Class IIIB ❑ Cryogenic ❑ Explosive LID 11FIEDPETROt EUM GAS(LPG. L.P- GASI 0 Flammable— Solid— Gas ❑ LPG In BLDGS -not accessible to public ❑ L Hazardous Waste la t Ld � LPG In BLDGS -accessible to Ilia public ❑ Highly Toxic In 1-LBconlalners ❑ Infectious Agents LPG In public assembly buildings. Q� Irrltanls LPG at construction sites. ❑ LPG outside Non-Fl0 ❑ Organic PeroxisCtlemlcal Organic Peroxide N.F.P.A.704 HAZARD RATING 0 ❑ Other Health Hazard Oxidizer NOTE: Place 4 Flammability nmrog ❑ Pesticide it Aax '� 3 ❑ Pyrophorlc Health Reactivity ❑ Radioactive ❑ Sensitizer V ❑ ❑ Toxic Unstable (Reactive) Special Haz SpSp Haz Hazards ❑ Water Reactive -yy- RAD (Circle all Ihal Apply) .R.A. Title III, Tier 11 RaDortlna Form and the uniform Flrn rnrie Pa rtp / of REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: cease Monkec,l 4UL1 L,nCIVIwHL II'4VtN I UHY HLPOHT CHEMICAL DESCRIPTION Read ALL instructions before completing form CAS NUMBER: L11_L Li — U f _ 6 _ _ PRODUCT Chakdo El ® El ❑.• owl."4y. Solid Liquid Gas Pure Mix Is INS producl or any of Its Ingredlents on the SARA ExIremoly Hazardous Substance (EHS) list? II"YES" list EHS Name: - II "NO" Is the chemical stored In amounts greater j than 10.00o lbs9 I cH BLDG (Number or Address): Z(o� INVENTORY AMOUNTS MAX. AVG. ON ON ' SITE SITE Pounds ff7 T 4 J_ G, Cu.FIST HEALTH HAZARD nnrnadialu(aculu) 2sO 3I= Gallons ® Dolayod (chruNc) (use Actual quanllllaa) PEAK INVENTORY YES ©NO MONTHS) 1 2 3 4 5 6 T 6 g 10 11 12 YES NO EMICAL INGREDIENTS: TRADE SECRET —� CAS Number. (1_l -'L i�- A-- Ll r - g _ - _ Percent of Mlxlure: Jff05_a/o IngredlenlName:ta5e_ Wbn CAS Number: Ingredient Name: CAS Number: Ingredient Name: CAS Number: Irlgredlenl Name: CAS Number: ingredient Name: Percent of Mixture: % Percent of Mixture: Percent of Mixture: % Percent of Mixture: % SARA FORM p 002 Rev. 11-94 STORAGE INFORMATION (Non-Conlidentlal) Storage Locations Statement about how this chemical Is used: HAZARp ASSES ❑ Aerosol Products 0 Blasting Agent ❑ Carcinogen Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable_ Solid_ Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infections Agents R) Irritants ® Non-HazardodsChemlcal ❑ Organic Peroxide ❑ Other Health Hazard O Oxidizer l7 Pesticide CI Pyrophorlc ❑ Radioactive Q Sensitizer Toxic ❑ Unstable (Reactive) O Waler-Reacllve IQ- FI.AMMABt E/ OMBUSTIBt F L IO 110,�, [] Class lA Flash (] Class II [� Class1B Pointt ClasslllA Class1C 75 14 ClasslllB (o.u<'S4 caS►, Poi y.)+ 1.1001FIE I) PETROI Ftlha GAoil p , p ,Aq ❑ LPG hi BLDGS -not accessible to public ❑ LPG lu BLDGS -accessible to Ills public In 1-LB containers ❑ LPG In public assembly bulldings. ❑ LPG at conshuctlort silos. C) LPG outside N.F.P.A. 704 HAZARD RATING NOTE:Pixea4 Flammability norsli J in wx \ Health 1 Q Reactivity \I — Special II lazards —W OX COR RAD (Circle This Chemical Inventory Report Form meals the reporting requirements of S.A.R.A. Title III, Tier II Reporling Form and the Uniform Fire Code. ilnal Apply) Page ___L of � UhtMIUAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, UJ5 FACILITY NAME: G_20Ma-1 _A+{ BLDG (Number or Address): 9 CHEMICAL DEStRIPTION INVENTORY AMOUNTS Read ALL lnalnrcllona before completing form Max. Avq, a. ON ON CAS NUMBER: Lh 1 K C U ( - �— _ _ SITE SITE YJ PRODUCT OR LADEL) NAME; c VJ i El ® El- --• • •-•• HEALTH HAZARD Cho h e1 © ® hnriwsdiale (ecule) "14FPY: Solid Liquid Gas Pure Mix ® Delayed (chronic) Is this producl or any of Its Ingredients on the SARA Eallemely Hazardous Substance (EHS) list? ❑ YE S ® N O' II "YES" list EHS Name: 11 "NO" Is Ilia chemical stored In amounts greater Il,all ,e.eao Ibs? (Cl YES ONO CHEMICAL INGREDIENTS: TRADE SECRET: LI CAS Number, Percent of Mlxlure: �:rS_% Ingredlenl Name:_ (��-�-}j� CAS Number.——�----�— Ingredlenl Name: CAS Number: Ingredient Name: Number: Ingredient Name: CAS Number: Ingredient Name: Percent of Mixture: % Percent of Mixture: Percent of Mixture: Percent of Mixture; % Pounds vW.1 1.0 55 40 Gallons (use actual quanilllas) PEAK INVENTORY MONTH(S) SARA FORM / 002 Rev. 11-94 S. Hol1 _ STORA E INFORMATION (Non-Conlldenllal) Storage Locations Statement about how this chemical fs used: 1 2 3 4 5 8 7nf i�n^�- niPr:,�L_ �a:L ALL ONT (Circle all Ihal Aooly, YlA�ARD CLASSES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable_ Solld _Gas ❑ Hazardous Waste ❑ Fllghly Toxic ❑ Infectious Agents R7 Irritants 9 Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophoric ❑ Radioactive fq Sensitizer CI Toxic ❑ Unstable (Reactive) ❑ Water-Reacllve FLAMMAE/ OMIFO IDS 8 ❑ Class IA SClass ll Class 1 B Point Class IIIA Class 1C y Class IIIB /owes c, porn{ t.I�UIFIED P�TROI Ell��re��ar i p r• ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 118 conialners HLPG In public assembly buildings. LPG at conslrucllon silos. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place a.r Flammability in in lox Health L Reactivity Special Hazards OX COR RAD This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title Ill. Tier II Reporting Form and the Uniform Fire Code. Pal Apply) Page -L of REPORTING PERIOD From: JAN. 1, to: DEC. 31. FACILITY NAME: i�SP, M'i, ", , -L( L) UHLMIGAL INVENTORY REPORT CHEMICAL DESCRIPTION Read ALL Instructions before completing form CAS NUMBER: C4 u c . (— _ — PRODUCTOR asl e O I ! 1411 $rurids i� ;LABEL) NAME: V 1 1 W.p , � r_ E, n "Wy: Solid Liquid Gas Pure MIX Is this product or any of Its Ingredients on the SARA Exlremoly Hazardous Substance (EHS) Its[? BLDG (Number or Address): INVENTORY AMOUNTS MAX. AVQ. ON ON SITE SITE c�ro` Pounds A r 6nrnadiara(acute) 2,Qt?C7 _,+CW Gallons ronl Dalayad(chc) fuse ac ut al quanlUlea) YES If"YES" Ilsl EHS Name: It "NO" Is the chemlcal stored In amounts greater then 1U,Ooolbs7 ❑YES CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: PEAKINVENTORY NO MONTH(S) 1 2 3 4 5 6 11 0 12 , ALL MONTH Y I rrlr'la vu a'.. Percent of Mixture: aka IngredlenlName:_ 1 MSnS CAS Number: Ingredeenl Name: CAS Number: Ingredient Name: CAS Number: Inuredlent Name: CAS Number: Ingredient Name: Percent of Mixture: % Percent of Mixture: Percent of Mixture: % Percent of Mixture: % SARA FORM k 002 Rev. 11-94 �Q kth{olI STORAGE INFO MATION (Non-Conlldenllal) Storage Locations Statement about how this chemical Is used: _WQS+P n I HAZARD C_ .LgSS�S ❑ Aerosol Products ❑ Blasting Agent El Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Rammable_Solid._Gas ❑ Hazardous Waste ❑ 1-flghlyToxic ❑ Infectious Agents Irrllants . Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide 0 Pyrophorlc ❑ Radioactive Sensitizer ❑ Toxic Cl Unstable (Reactive) ❑ Waler-Reacllve FIAMMABL.E/ .OMB ISTIBLF �.IO IIDS; 0 Class I Flash Class II 8 Class 18 Point Class IIIA Class I WA_ ® Class IIIB LIQUIFIED PETROI 11M rec n Dr r p ,Aq ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB conialners LPG In public assembly bulldings. LPG at construction sues. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE.-PAW-4 Flammability naimig in box J Health .l. Reactivity Special Hazards _W_ OX COR RAD This chemlcal Inventory Report Form meets the reporting requirements of S.A.R.A. 'Mlle III, Tier II Reporting Form and the Uniform Fire Code. Ilia) Apply) Page I of _ REPORTING PERIOD From: I, . 1, to: DEC. 31, CHEMICAL INVENTORY REPORT Ctwk ea ❑ ® ❑- ---❑.. ®�miwdima(acu�a) _ 3� Gallons rrdr+PPY: Solid Liquid Gas Pure Mix Is tills product or any of Its Ingredlenls on the SARA ❑ Exlromoly Hazardous Subslance (EHS) list? ll"YES" Ilsl EHS Name: If "NO" Is file chemical stored In amounts greater than 1.0.0oo ibs4 CHEMICAL INGREDIENTS: IIII ( that I Apply) TRADE SECRET: CAS Number: m A-- X- — — Porcenl of Mixture: I Ingredieni Name: CAS Num Ingredient Name: CAS Number; Ingredlent Name: FACILITY NAME: CHEMICAL DESCRIPTION Read ALL Instructions before completing form CAS NUMBER: M-L X PRODUCT OR ;LABEL) NAME:TF 1 a1 I BLDG (Number or Address): INVENTORY AMOUNTS MAX. AVG. ON ON SITE SITE c U Pounds C Cu.FLSTP SARA FORM B 002 Rev. 11-94 STORAGE INFdRMATION (Non•Conlidenllal) Storage Locations Delayed (chrailc) (use actual quantities) ,:.. �1LCNBINYRNTONV: RSFbRTINp" r:t0U8 iAeC'NOa OIRFC YIONB PEAK INVENTORY Statement about how this chemical Is used: YES ®NO MONTH(S) 1 2 3 4 5 (i . H u fn I� .j r-- . t_ 7 8 9 0 11 12 / ui �,'� n ✓Yl„ YES ®N Q LL ONTt l Circle all 1 a FLAMMABLE/COMBuSTIBLE ,IO IL ID,S (] Class 1A Flash (] Class II 8 Class 1 B Point Class IIIA Class 1C 70 ® Class IIIB LID IIFIED PETROI FUM rec /Lp0 1 p ,AS ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB conlalners 8 LPG In public assambiy bulldings. LPG at conslrucllon slles. ❑ LPG outside F mber: ❑ Organic Peroxide N.F.P.A. 704 HAZARD RATING ❑ Other Health Hazard NOTE: I'We0-4 Flammability — — Percent of Mixture: % ❑ Oxidizer nanny ❑ Pesticide m baxnt Name: ❑ Pyrophoricmber: ❑ Radioactive 11ea111t pReacllvily Percent of Mixture: Sensitizer❑Toxic nt Name: ❑ Unslable (Reactive) Special tlazards ❑ . Water-Reaclive �-W- OX COR HAD Title Chemical Inventor Re Porting q (Circle all that Apply) y port Form meals there rtin requirements o1 S.A.R.A. Title 111, Tier II Reporting Form and the Uniform Fire Code. Page Of Percent of Mixture: % Percent of Mixture: % HA AM CLASSES ❑ Aerosol Products ❑ Blasting Agent E] Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable _ Solid _ Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents R1 Irritants ® Non -Hazardous Chemical REPORTING PERIOD From: JAN. 1, to: DEC. 31, CHEMICAL INVENTORY REPORT199R FACILITY NAME: BLDG (Number or Address): CHEMICAL DESCRIPTION INVENTORY AMOUNTS Read ALL Instructions before complefing.form MAX. AID 41 ON ON � Xf CAS NUMBER: M _�L K�� _ — ` SITE sirE F PRODUCT OR L1 v�C �^ / f} 11 $rates v \ Pounds LABEL) NAME: O , (N TF l i 3e i 04 F. ) rnyslCALCOMPOSITIoN HEALTH HAZARD ex- Ln1 am ❑ 0 ❑ ❑ (4Inunadale(acuta) u.ra�ry: Solid Liquid Gas Pure Mix ��I � I� oolayeJ (chroNc)s this product or any of Its Ingredients on the SARA �+ Exlromely Hazardous Substance (EHS) list? YE S B N O, If "YES" list EHS Name: II "NO" Is Ithe chemical stored In amounts greater YES than tg0001bs7 ❑ 1 ES ® NO CHEMICAL INGREDIENTS: TRADE SECRET: C� CAS Number: kc TO �, e Percenl of Mixture: a/ Ingredient Name: Ingredient Name: CAS Number: Ingredient Name: CAS Number: Ingredlenl Name: CAS Number: Ingredlent Name: 0 V"n-n ri�i ± k % , , . - Percent of Mixture: % Percent Of Mixture: % Percent of Mixture: % Percent of Mixture: % Cu.FI. Gallons (use actual quanthles) SARA FORM N 002 Rev. 11-94 mouth � l y STORAGE INFORMATION (Non-Conlldenllal) Storage Locations PEAK INVENTORY Statement about Ihow this chemical is used: MONTH(S) 1 2 3 4 5 8 7 8, _� _10 11 12 uiv f 5 TYPE HAZARQ CLABBER ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable —Solid —Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents ;I Irritants R) Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophoric ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive r FLAMMABLE /('OMBUSTIBLF LIO IIDS ❑ Clasu 1A Flash ❑ ClaSS11 8 Class 1 B Point Cluss IIIA Class 1C 9aa Class IIIB LIO )IF1ED PETROL EIIAm r'ec It oU r p AR1 ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB containers LPG In public assembly bulldings. LPG at construcllull Silas. ❑ LPG outside N.F.P.A.704 HAZARD RATING NOTE: PIace&4 Flammability gal, x �J 1 Health Q .�. Q Reactivity Special Hazards —w- OX COR RAD This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Reporting Form and the Uniform Fire at Clrcle ode. III a Apply) Page _1__ Of REPORTING PERIOD From: JAN. 1, to: DEC. 31, l:HtMICAL INVENTORY REPORTIg98 FACILITYNAME:(_�anc, hn.....,, n .I. 1 CHEMICAL DtSCRIPTION Reed ALL Instructions before completing form CAS NUMBER: PRODUCT OR E. PII, s &,j LABEL) NAMME: � 1 /lP CHEMICAL INGREDIENTS: CAS Num r: check as 0 ❑ " IIWIaaxy: Solid Llquld Gas Pure Mix Is Ihls product or any of Its Ingredients on the SARA PEAK INVENTORY Extremely Hazardous Substance (EHS) list? ❑ YES f NO MONTH(S) II "YES" list EHS Name: It "NO" Is Ilia chemical stored In amounts greater Than 10,000lbs? pply) � TRADE SECRET: 1 e�rM Immediala (acule) Delayed (chwil,) Y 1 2 3 4 5 6 7 8 11 12 E S �x1 N O (Circle all that A Percent of Mixture: �a�e _ Ingredient Name: y p l<Pl A B-1 Ingredient Name: n -km\ CAS Number: �1 Ingredient Name: CAS Number: Irlgredlenl Name: CAS Number: Ingredient Name: Percent of Mixture: OJ % Percent of Mixture: % Percent of Mixture: % Percent of Mixture: BLDG (Number orAddress): INVENTORY AMOUNTS MAX. AVG. ON ON G SITE SITE 1 01-a` Pounds Q Cu.FI.STP .—_ _ � Gallons (use actual quanlllles) SARA FORM N 002 Rev. 11-94 STORAGL INFORMATION (Non-Confldenllal) Storage Locations Statement about how this chemical Is used: HAZARD - A SES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable — Solid_ Gas ❑ Hazardous Waste ❑ HlghtyToxlc ❑ Infectious Agents Irritants Non-HazardoUs Chemical ❑ Organic Peroxide ❑ Other Health Hazard Cl Oxidizer IO Pesticide ❑ Pyrophoric O Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive A FLAMMABLE/COMBl1STI13 E I Inlunc [I Class 1A Flash (] Class II Class I Point EJ Class IIIA Class 1C ,39J E] Class IIIB hI.M!!I U PETROLEUM GAS (LPG- I a G • qj ❑ LPG In DLDGS -not accessible to public ❑ LPG In BLDGS-accessiblo to the public In 1-LB containers ❑ LPG In public assembly buildings. ❑ LPG al construction sues. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place0.4 Flammablllly AaM9 In box Health p O Reacllvlly Special Hazards _W- OX COR RAD This Chemical Inventory Report Form meets Ills reporting requirements of S.A.R. A. Title III, Tier II Reporting Form and ilia uniform Fire Clods. II is( Apply) Page / of SARA FORM N 002 Rev. 11-94 STORAGL INFORMATION (Non-Confldenllal) Storage Locations Statement about how this chemical Is used: HAZARD - A SES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable — Solid_ Gas ❑ Hazardous Waste ❑ HlghtyToxlc ❑ Infectious Agents Irritants Non-HazardoUs Chemical ❑ Organic Peroxide ❑ Other Health Hazard Cl Oxidizer IO Pesticide ❑ Pyrophoric O Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive A FLAMMABLE/COMBl1STI13 E I Inlunc [I Class 1A Flash (] Class II Class I Point EJ Class IIIA Class 1C ,39J E] Class IIIB hI.M!!I U PETROLEUM GAS (LPG- I a G • qj ❑ LPG In DLDGS -not accessible to public ❑ LPG In BLDGS-accessiblo to the public In 1-LB containers ❑ LPG In public assembly buildings. ❑ LPG al construction sues. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place0.4 Flammablllly AaM9 In box Health p O Reacllvlly Special Hazards _W- OX COR RAD This Chemical Inventory Report Form meets Ills reporting requirements of S.A.R. A. Title III, Tier II Reporting Form and ilia uniform Fire Clods. II is( Apply) Page / of L,NLMIL;AL INVLNTORY REPORT REPORTING PERIOD From: JAN. 1. to: DEC. 31, FACILITY NAME:G' ec15e 'mon -4LAq BLDG(NumberorAddress): CHEMICAL DESIbiiiPTION INVENTORYAMOUNTS Read ALL Instructions beIons completing form MAX. AVG. ON ON CAS NUMBER: SITE slrE PRODUCT OR l (LABEL) NAME: �qn!1 S X C,Ak k ay ❑ ❑ ❑ �1 "" IA".* Solid Liquid Gas Pure Mix Is [his product or any of Its Ingredients on the SARA Extremely Hazardous Substance (EHS) list? (addI};ve, Pounds Cu.FI.S KTH HAZARD C hmweale(acute) 5 Gallons Delayed (chrodc) prse actual quanllliea) YES Cl N If "YES" list ENS Name: ll'NO" Is Ilse chemical stored In amounts greater — Ihan 10.000Ibs? ❑ YES NO CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: -(2 3 a _ _ - O O - O Percent of Mixture:_a/e Ingredient Name: \ Y 1r7 } ( � CAS Number. Ingredlent Name: CAS Number: Ingredient Name: CAS Number: Ingredlent Name: CAS Number: Ingredient Name Percent of Mixture: % Percent of Mixture: % Percent of Mixture: % Percent of Mixture: PEAKINVENTORY MONTH(S) 1 2 3 4 5 7 _A _A0 I I ONT (Circle all that ADDlvI SARA FORM M 002 Rev. 11.94 5c h .H 11 STORAGE INFO MATION (Non-Conlldentiai) Storage Locations Slatemerll about how [his chemical Is used: [� e HAZAR TYPE --fit •LASS 4 ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive p)i (] Cryogenic ❑ Explosive ❑ Flammable_Solld_Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents 9 Irritants 9 Non-I-lazardousChemlcal ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc 11 Radioactive ❑ Sensitizer ❑ Toxic O Unslable (Reactive) ❑ Water-Reacilve FLAMMABLE /COMBLISTIBIf= [ IO()IpS: ❑ Class to Flesh [] Class II 8 Class 18 Point Class IIIA Class 10 p�� ® Class 1118 LIQUIFIED PETROL FUM GAc (L P L P +A41 ❑ LPG Ir1 BLDGS -not accessible to publlc ❑ LPG In BLDGS -accessible to the public In 1-L.B containers ❑ LPG In public assembly buildings, [� LPG at construclion Giles. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Placeo4 Flammability natuiy "J in � O Health Reactivity Special Hazards —VY OX COR RAD 7hla Chemical Inventor Re po g q Reporting •. (Circle all Ihal Ap ly) y port Form maels the reporting requirements of S.A.R.A. Title III, Tier II Re rtin Form and the Uniform Fire Code. Page / Of L CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, I FACILITY NAME: G(-QRSe " #yu BLDG (Number or Address): 4ga G CHEMICAL iD CRIPTION INVENTORY AMOUNTS Read ALL Instructions before completing form MAX. AVG. c L ON ON f� ICAS NUMBER; >b sl1'E SITE c PRODUCTOR 1 I,. I r'� OI I Poundsly 1 ;LADEL) NAME; l r T ► 51 r Yk oYYY) d nil l� Lc� v,n �� _ L MYY51CA1- COMPOSITION C:ha:4 am O W El El 0 11WIA 1r: Solid Liquid Gas Pure Mix Is this prodticl or any of Its Ingredients on Ilia SARA Extremely Hazardous Stibslanco (EHS) list? Cu.FI.S FLTH laaw HAZARD Irtrrwtfn ala(eculs) —I Gallons Delayed (ch(onic) (use actual guanlllles) YES I/] N It"YES^ list EHS Name: 11 "NO" is the chemical stored In amounts greater Ihen 10,0001bs? q"i ® NO CHEMICAL INGREDIENTS: TRAD—J CAS Number; .LP A -7 -�L — Percent of Mixture: IQ -7S % IngredlenlName:Pe r `eu n iO , CAS Number: higredlenl Name CAS IdCAS ld mu ber:r Ingredient Name: CAS Number: Irlgredlenl Name: CAS Number; Ingredlonl Name: Percent of Mixture: Percent of Mixture: % Percent of Mixture: % Percent of Mixture: % SARA FORM N 002 Rev. 11-94 STORAGE INFORMATION (Non-Conlldenlial) . Storage Locations PEAK INVENTORY I Statement about how this chemical Is used: MONTH(S) -Qi J-D 1R- p,�-rir- %�vIxy�kth'f e 1 2 3 4 5 8� s of 7 8 9 An it 12 (Circle all that TY HAZARD GLAD D Aerosol Products ❑ Blasting Ageill ❑ Carcinogen ❑ Corrosive pH Q Cryogenic ❑ Explosive ❑ Flammable_ Solid_ Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infecil us Agents �J Irritants ® Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Wa(er-Reactive FLAMMABLE/C [I Class 1A kffiLU(BLE Flash [] LIQUIDS: Class II (1 class1B Polnl 8 Class IIIA 6 Class 1C 390 Class1118 LIOt11FIED PETROI 11=1IU I-A0 fl p , L P GARI ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB containers LPG In public assembly bulldings. LPG at conslrucilon silos. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place o o Flammability newly �J in tux Health p Reactivity Speclal Hazards -W OX COR RAD This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Reporting Form and the Uniform Fire Code. II Vial Apply) Page of REPORTING PERIOD From: JAN. 1, to: DEC. 31, CHEMICAL INVENTORY REPORT FACILITY NAME: CHEMICAL DESCRIPTION Read ALL lnstructlona before completlnq form CAS NUMBER: ry) _� A te_ _ PRODUCT OR n � �ik>Q� (LABEL) NAME) v�Inn 5 Chock am ❑ rnI�rsICRLCOMPOSITION IQ . 11 El® HERLTH HAZARD Ilnrnediale (acula) "elaAwy: Solid Liquid Gas Pure MixR1Dalayad(ehroNc) Is this producl or any of Its Ingredients on Iho SARA Extremely Hazardous Subslance (EHS) list? ❑YES ® NO II"YES•' list EMS Name: 11 "NO" Is Ills chemical stored In amounts greater Ihun 10.000lbs7 ❑ YES 4 NO CHEMICAL INGREDIENTS: TRADE SECRET: C� CAS Number, (p -2 -3-3 A _ - O _ 5 Percent of Mlxlure:(DS -75% Ingredient Name: 1 U�XY1 1 , P 1fs CAS NumMr• Ingredient Name: ---------------- CAS Number: Ingredient Name: CAS Number: Ingredient Name: CAS Number: Ingredient Name Percent of Mixture: Percent of Mixture: Percent of Mixture: Percent of Mixture: BLDG (Number or Address): '?a (00 INVENTORY AMOUNTS m ON A ON ON SITE SITE Pounds lT/ 1 1 i 9 5 Gallons (use actual quanillias) PEAKINVENTORY MONTH(S) 1 2 3 4 5 6 7 B 9 111 11 12 SARA FORM M 002 Rev. 11-94 STORAGE INFOhMATION (Non -Confidential) Storage Locations Slatemmenjabout how this chemical Is used: .ail _ .iL) Off°/ t041/71 /� (�2 I r Ir7�J�i HAZARD CLAGgEg ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable _ Solid— Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents irrilants Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive 0 Sensitizer ❑ Toxic 0 Unstable (Reactive) ❑ Wafer-Reacllve Ff�AMMABLE / .ONUSTIBLE ❑ Class 1A Flash El LIO IIDS: Class 11 8 Class 1 B Classic Point ItA7 �] Class IIIA Class IIIB LIQUIFIED P TROL FIIAM f,Aq fl p , I p GA41 ❑ LPG In BLDGS -riot accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB containers 8 LPG In public assembly buildings. LPG at construction sues. ❑ LPG outside N.F.P.A.704 HAZARD RATING NOTE:PIaoaria Flammability nnow in box ! Health L _ p Reactivity Special Hazards —W. OX COR HAD (Circle II 111 This Chemical Inventory Report Form meats the reporting requlremente of S.A-A.A. Title III, Tier II Reporting Form and the Uniform Fire Code. Page Page _/_ of j REPORTING PERIOD From: 'AN. 1, lo: DEC. 31, CHEMICAL INVENTORY REPORT FACILITY NAME: ( Msi-nhe BLDG (Number or Address): CHEMICAL DESCRIPTION INVENTORY AMOUNTS Read ALL Instructions before completing form MAX. AVG. c 41 L" ON ON $ CAS NUMBER: �� X �r . ez SITE SITE F a E PRODUCT OR (' Pounds [LABEL)NAMEA1knn�(X—� h;al' Yoe f trrynr'rp. It 'tmvl-4--,i Loolerrvh PHYSICAL COMPOSITION — �— Grw:A ay ❑ R) ❑ ❑ I rr-rauxy: Solid Liquid Gas Pure Mix Is this product or any of Its Ingredients on the SARA Extremely Hazardous Substance (EHS) list? Invneuata(acwa) �_ GWas) (use actualquanl Deloyad (chronic) _ YES 16"d NO 11 "YES" list EHS Name: It 'NO" Is ilia chemlcal stored In amounts greater Ihan10.000lbs? ❑ YES NO CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number. LR y -7 L Percent of Mixture: �5 % Ingredient Name:__fle��' CAS Number: Ingredlenl Name: CAS Number:— — — — — Ingredient Name: CAS Number: Ingredient Name: CAS Number: Ingredlenl Name Percent of Mixture: Percent of Mixture: % Percent of Mixture: % Percent of Mixture: % PEAKINVENTORY MONTH(S) 1 2 3 4 5 6 7 8 12 ONTH (Circle all that ADDIvI FORM p 002 Rev. 11-94 STORAGE INFOI(MATION (Non-Confidentlal) Storage Locations Statement about flow this chemical Is used: HAZARD GLAUU ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable_ Solid_ Gas ❑ Hazardous Waste ❑ HlghlyToxlc ❑ Infectious Agents Irritants Non -Hazardous Chemical Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive OF HAZARDS) FLAMMABLE/COMB 1STIH F t IQ W-, [] Class 1 A Flash Class it 8 Class 1 B Classic Point -1,40 8 Class IIIA Class IIIB LIQUIFIED PETROI UM r•,AS ( PG l._ p GASI ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-LB conlalnala LPG In public assembly buildings. LPG at construction Silas. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: PlAceo 4 Flammability nolin0 rn Wx \ I Health O Reactivity Special Hazards -,W- OX COR RAD (CI cl II 1 r e a I let Apply) Thla Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form slid the Uniform Fire Code. Page / Of REPORTING PERIOD From: JAN. 1, to: DEC. 31CHEMICAL INVENTORY REPORT, FACILITY NAME: (Ll LA BLDG (Number or Address): CHEMICAL DESCRIPTION INVENTORY AMOUNTS Read ALL Instructions before completing form. MAX. AVG. ON ON CAS NUMBER: , t�i _ — _ — SITE SITE U t•' 0. PRODUCT OR \\l � VC 3 £ Pounds (IABEL)NAME: A — &I )QA ►'' dealif'y1 Cllwt all ❑ Cu.FI.STP �— PHYSICAL C014POSITION ® ❑ ❑ �( HEALTH HAZARD Immediele ® (&cute) Gallons °ulwar: Solid .- Liquid Gas Pure Mix Delayed(CtWc"C) (use t gtanUues) Is this product or any of Its Ingredients on Ilia SARA Extremely Hazardous Substance (EHS) list? ❑YES N 11 "YES" list EHS Name: II "NO" Is 1110 chelrlical stored In amounts greater than Io.000Ibs7 ❑ YES ®NO CHEMICAL INGREDIENTS:. TRADE SECRET: C] CAS umber. -a O - 6 Percent of Mixture:(,_% Ingredient Name: O l lrn I'C' A-i � �S CAS Number: Ingredient Name: CAS N1CAS mr hero Ingredient Name: CAS Number. Ingredient Name: CAS Number: blgredient Name: Percent of Mixture: Percent of Mixture: % Percent of Mixture: % Percent of Mixture: % PEAKINVENTORY MONTH(S) 1 2 3 4 5 7 a 9 in 11 SARA FORM N 002 Rev. 11-94 STORAGE INFORMATION (Non-Conlldentlal) Storage Locations a Statement about how tills chemical is used: �e MIN -1 Ali TYPI HAZARD CLAaM ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable_ Solid_ Gas ❑ Hazardous Waste ❑ Highly Toxic Carbus}. ble ❑ Infectious Agents ud i� Irritants ❑ Non -Hazardous Chemical ❑ Organic Peroxide ❑ Olher Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlo ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Waler-Reactive FLAMMABLE/COMBLIST)BL ❑ Class 1A Flash ❑ F LiQL111)S Class II 8 Class 1 B Class Point ® Class IIIA 1C -ij�_a Class 1118 LIOLIIFIED PETRO UM reSrr ar I p GAS1 ❑ LPG In BLDGS rlol accesslble to public ❑ LPG in BLDQS -accessible to Ilia public In 1-LB conlalners LPG In public assalllbly buildings. LPG al construction silos. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place o .r Flammability n4kuj �J W box Health Reactivity Special Hazards _W- OX COR RAD (Circle all Ihal Ap ly) Tills Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title 111, Tier 11 Reporting Form and the Unitorm Fire Code. Page of / REPORTING PERIOD From: JAN. 1, to: DEC. 31 FACILITYNAME: C7T QgSe_fftnn4n.. 4l 111 UHLMICAL INVENTORY REPORT CHEMICAL DESChIPTION Read ALL Instructions before completing form CAS NUMBER: roi KA:u )%- _ �� — — PRODUCTORC-0ICI C (� /� nt�o Lx-) LABEL)NAME:-�Q-1 xl� lfli_>el Mt�r.1c 1 rrdran i. Solid Liquid Gas Pure Mix Is this prodml or any of its Ingredients on the SARA Exiromely Hazardous Substance (EHS) list? I BLDG (Number or Address): INVENTORY AMOUNTS MAX. AVG. v ON ON SITE SITE Pounds N 1 V 4.1 r.V iLTH HAZARD rrrunodtate (.cure) Gallons Delayed (chrc"c) (rise actual quw tittes) MM-FR© II "YES" Ilsl ENS Name: If "NO" Is the chemical stored In amounts greater Ihan 10,000lbs? ❑ YES NO CHEMICAL INGREDIENTS: TRADE SECRET: C� CAS Number. 8 2 Q $ — (— - ja 2 - to Percent of Mixture: R—% Ingredient Name:_1-HA- )M\e1lA_IM D-,C, T111a CAS Number: Ingredient Narne: CAS Nllmbor:— — — — — Ingredient Name: CAS Numbor: Ingredient Name: CAS Number: Ingredlenl Name: Percent of Mixture: % Percent of Mixture: % Percent of Mixture: % Percent of Mixture: SARA FORM N 002 Rev. 11-94 1 STORAGL INFORMATION (Non-Conllden(lal) Storage Locations PEAK INVENTORY Statement about how this chemical Is used: MONTH(S) 1 2 3 4 5 6 7 11 12 >r P LtPyT l nr 1 i >p LOLL MONTI-( Mai nf (Clrcle all that AnDIA HAZARD .LASRFS ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corroslve pH ❑ Cryogenic ❑ Explosive ❑ Flammable_ Soild._Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents 1Z1 Irritants ® Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer Cl Pesticide ❑ Pyrophorlc ❑ Radioactive ❑ Sensitizer ❑ Toxic Q Unstable (Reactive) ❑ Water-Reacllve FLAMMABLE/COMBUSTIBLE 110 1tnS [] Class 1A Flash Class II 8 Class I Point Class IIIA Class 1C k2$_ ® Class IIIB LIQUIFIED PETROI F116� ras (t P . 1 p rqS► ❑ LPG in BLDGS -not accesslblo to )hubllc ❑ LPG In BLDGS -accessible to the public In 1-LB containers ❑ LPG In public assembly buildings. ❑ LPG at consirucllun sites. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Praca o 4 Flammability naUny J in Lux \ J Health Reactivity Special Hazards -W- OX COR HAD (Circle all that Apply) This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Reporting Form and the Unllorm Fire Code. Page .L of _[, REPORTING PERIOD From: JAN. 1, to: DEC. 31 CHEMICAL INVENTORY REPORT FACILITY NAME: L. CHEMICAL DESCRIPTION. Read ALL Instructions before completing form CAS NUMBER: PRODUCT OR%1d f�9Ie (� fi VC, (LABEL)14AME: f2b. lP lnTrxl " 'i i,ocRac o7 PHYSSICALCOMPOSITIOH HEALTH HAZARD chock aY ❑ IW ❑ ❑ M Innediala(aculu) "wI DANY: Solid Liquid Gas Pure Mix ® Delayod (Chrordc) Is this product or any of its Ingredients on the SARA ❑ Extremely Hazardous Substance (EHS) list? EYE: SN O II "YES" Iisl EHS Name: If "N(Y' Is the chemical stored In amounts greater Illan 1e.000 lbs? ❑YES ®N O CHEMICAL INGREDIENTS: TRADE SECRET: C] CAS Number: -L 3 3 Q — — - a Q - _7 Percent of Mixture: l90 0/1 Ingredient Name:_ X U UP rip _ CAS Number:. �- — — — — O Percent of Mixture: IngredlenlName: SSDRyneano l CAS Number: q a - op Percent of Mixture: /O Ingredient Name: 1 J i a re jn'op � � C� O kol CAS Number: Ingredient Name: CAS Number: Ingredient Name: Percent of Mixture: % Percent of Mixture: BLDG (Number or Address) INVENTORY AMOUNTS MAX. AVG.' ON ON �p{j SITE SITE � Pounds N 1 Cu.F1.STI 5 Gallons (use acluel quanlllles) PEAKINVENTORY MONTH(S) 1 2 3 4 5 E 7 B 9 10 11 12 all SARA FORM 111002 Rev. 11-94 s. STORAGE INFORMATION (Non-Confldentlal) Storage Locatlons Slatemeni about how this chemical Is used: HAZARD CLASSe� ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ® Flammable_Solld_Gas ❑ Hazardous Waste ❑ HlghlyToxic ❑ Infectious Agents PQ Irritants ❑ Non-hlazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radloacllve ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water-Reaclive FLAMMAHLEIGOMBUS_71BLE .IOIIO4c Class to Flash (] Class11 Class 1 B Point Class IIIA Class 1C 6q ® Class 1118 LIOLIIFIED PETROL I1M rA^� f�pG. L•p_GAS) ❑ LPG In BL0GS -not accessible to public ❑ LPG In SLOGS -accessible Io the public In 1-LB conlalnel9 LPG In publle assembly bulldings. LPG at conslnlcllon sites, ❑ LPG outside N.F.P.A.704 HAZARD RATIO NOTE: PI -we es Flammability naWd �J in wX 3 Health L 00 Reactivity Special Hazards -W-. OX COR RAD This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III, Tier II Reporling Form and the Uniform Fire Code. II tllal Ap ly) Page// of L CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: CHEMICAL DESCRIPTION Read ALL Instructions before completing form CAS NUMBER: (h)- L— PRODUCT OR &1a E08�--- c,�d r1i U2� :LABEL) NAME: -&Id 2 in Tn Irk CM Prtt np r, Cnde;k atl ❑ ® ❑ --❑-- OUTAP rr: Solid Liquid Gas Pure Mix Is this product or any of its Ingredients on the SARA Extiomoly Hazardous Substance (EHS) list? _I BLDG (Number or Address): INVENTORYAMOUNTS MAX. AVG. ON ON J7 SITE SITE Pounds y 1_ Gro Cu.FI.STP 9LTH HAZARD brurwdiato(aculd) �_ 5 Gallons Ddlayad (chrodc) (use aclual quantities) � �®Nltti7� II "YES" Ilsi EHS Name: I("NO" Is the chemical stored In amounts greater C Iran 10,00o lbsy ❑ YES M NO CHEMICAL INGREDIENTS: TRADE SECRET: C] CAS Number: le --A -1 L 21, — - -�a S -2 Percent of Mixture: 2 _ % Ingrodlen(Name: &-9. p — r — — — Percent of Mixture: nQ—_% Ingredlenl Name:.. CAS Number: — — — — — — — — — Percent of Mixture: 0% Ingredient Name: CAS Number: - — — -- — — — — _ Percent of Mixture: Inuredlont Name: CAS Number: - — — — — — — _ — Percent of Mixture: Ingredlenl Name: PEAKINVENTORY MONTH(S) 1 2 3 4 5 8 7 8 9 11 12 ONTIJS (Circle all that AnDlvl SARA FORM N 002 Rev. 11.94 (RAGE INFORMATION (Non-Conlldenllal) Storage Locations Statement about how this chemical Is used: HAZARD CI ASSES ❑ Aerosol Products FLAMMABLE/ 1RTIBLE ❑ Blasting Agent .OMB Class 1A Flash LIQUIDS@ (] Class If ❑ ❑ Carcinogen , Corrosive Class1B Point 8 Class IIIA ® pH Class 1C oo ClasslllB ❑ Cryogenic ❑ Explosive t 17 Flamm able_ Solid —Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agenis COMbus+i bl�- R Irritants �. %ul d ❑ Non-1azardous Chemical ❑ OrganlcPeroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive �10 11FIED PETROI ELIM raS rLPG. LP- >'ARI ❑ LPG In BLDGS •not accessible to public ❑ LPG In BLDGS -accessible to the public In 1 -LB conlalnors ❑ LPG In public assembly bulldings. [J LPG at construction slles. ❑ LPG outside N.F.P.A. 704 HAZARD RATING DOTE: pwca o 4 Flammability it) Lox �J in ox Fleallh ' ¢ Reactivity Special Hazards -W- OX COR RAD C This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Title III; Tier II Reporting Form and the Unif( Ircle all Mat Apply) orm Fire Code. Page of L REPORTING PERIOD From: JAN. 1, to: DEC. 31 FACILITY NAME: r-,ron-6A M, 11 A , r -41-1 CHEMICAL INVENTORY REPORT CHEMICAL DESCRIPTION Head ALL Instructions before completing form CAS NUMBER: M _ " PRODUCT OR Goo Engle 1-ABEL)NAME: CO^1din -fni-C Totgl K� OAL- Gha;k am ❑ ® ❑ ❑ 0 °rlarl Y' Solid Liquid Gas Pure Mix BLDG (Number or Address): INVENTORY AMOUNTS MAX. AVG. ON ON SITE SITE Pounds C FI S u. TP ILTH HAZARD Imm°dlula (aCuld) Gallons D°layod (chronic) {use actual quenlillea) Is this product or any of Its Ingredients on the SARA �+ Extremely Hazardous Substance (EHS) Its[? YES N C II "YES" list EHS Name: II "NO" Is the chemical stored In amounts greater If 10.000 lbs, ❑ YES CHEMICAL INGREDIENTS: TRADE SECRET: CAS Number: a D _ (o Percent of Mlxture:(2�O Ingredient Name:_ Qc_ -ru)ie n l isi-i\�O CAS Numher: Ingredient Narne: 7CASNumber:— — — — — Ingredient Name: CAS Number: Ingredient Name: CAS Number: Ingredient Name: Percent of Mixture: Percent of Mixture: Percent of Mixture: a/° Percent of Mixture: SARA FORM N 002 Rev. 11-94 STORAGE INFORMATION (Non-Conlldenllal) Storage Locations PEAK INVENTORY Statement about how this chemical Is used: MONTH(S) 1 2 3 4 5 0 oral >P>n�n rip 7 B 9 10 11 12 (Circle all IIIaI Apply) HAZARD LA SEKyS TYPE OF HAZARDS) ❑ ❑ Aerosol Products Blasting Agent FLAMMABL.ElGOMBUsTIB1 E LIQUIDS; 11DS; ❑ Carcinogen [) Class 1A Flash fm Class II Class 1B Point Class IIIA ❑ Corrosive pH H Class 1C h 5 Class IIIB Cl Cryogenic ❑ Explosive t IQUIFIED PETROL E 1M A� (t PG LP �AS1 ❑ Flaminable_Solid_Gas ❑LPG InBLDGS•nolaccesslblotopublic ❑ Hazardous Waste ❑ LPG III BLDGS -accessible to the public ❑ Highly Toxic Carn6u&- i;We In1-LB containers ❑ Infectious Agents U'nj lad ❑ LPG In public assembly bull(Iings. [] LPG al ba Irritants ll' consirucllon silos. LPG outside .El Non -Hazardous Chemical ❑ Organic Peroxide N.P.P.A.704 HAZARD RATING ❑ El Other Health Hazard Oxidizer NOTE:1`1=800 Flammability ❑ CI Pesticide Pyrophorlc n„I,,„j '� Ind J ❑ Radioactive Health Reactivity — C) Sensitizer I V ❑ Toxic ❑ Unstable (Reactive) Special Hazards ❑ Water-Reacilve - W- OX COR RAD (Circle all that Ap ly) This Chemical Inventory. Report Form meals the reporting requirements of S.A.R.A. Title III, Tier 11 Reporting Form and the Uniform Fire Code. Page / Of _� CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, �G9R FACILITY NAME: CHEMICAL DESCRIPTION Read ALL lnalrrrcllons befOrD complellnn form CAS NUMBER: M-'- CL 1 1x (- P(IODUCT OR 02okci If. Card, +w-e) (l ADEL) NAME: �S 5 >,ar>eK PHYSILRLCOhIPOSITION HEALTH IIRZRRD Chwk am ❑ © ❑ ❑ M IIrwilodials(eculo) "Warwy: Solid Liquid Gas Pure Mix ® Delayed (chroac) Is this product or any of Its Ingredlonls on the SARA Exlrelnoly Hazardous Substance (EHS) list? ill YES ❑ N O ll "YES" Ilsl EHS Name: "NO" Is the chemical stored In amounts Illan 10,000lbs7 greater ❑ YES O N O ,if CHEMICAL INGREDIENTS: TRADE SECRET: r CAS Number: $ CL — — ' --(e Percent of Mixture: eO a/a IngredlenlName:AtJ`o{e.u.r-n 01'6 I(L{2, CAS Number: (]n -L � Percent of Mixture: —L_% IngredlenlName:_ jj4-ra(t.L-1,n, CAS Nurmbleer; '_ al —I r - +-� Q — — - _ Percent of Mixture: 5 % Ingredient Name: I fi uQ 111,x1 CAS Number: - — — -- — — — — — Percent of Mixture: a/a Ingradlenl Namo: CAS Number: - — — — — — — — — Percent of Mixture: % higredlanl Name: BLDG (Number or -Address): INVENTORYAMOUNTS MAX. AVG. c v ON ON G SITE SITE ci a` Pounds Cu. FLSTP = L_ Gallons (use actual quantities) PEAKINVENTORV MONTHS) 1 2 3 4 5 7 a 9 to 11 SARA FORM 111002 Rev. 11-94 STORAGE INFORMATION (Non-Conlldentlal) Storage Locations Statement about flow [his chemical Is used: HAZARD �I ASSFG ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen, ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable_Solid_Gas ❑ Hazardous Waste ❑ Highly Toxic Con,bushble El Infectious Agenls N) Irritants J ❑ Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive ❑ Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Waler-Reacllve E�AMMABI.E/COMB 1RTIBl E l IO IIDR E] Class 1A Flash ® Class II 8 Class 1B Point Class IIIA Class 1C lass 8 Class 11113 LL IOUIFIED PETROI 116■ r`Ac rl p I P GAR) ❑ LPG In BLDGS -nol occesslble to publlc ❑ LPG III BLDGS-accessIble to Ilia public In 1-LB cunlalners HLPG In public assembly buildings. LPG at conslrucllon sllus. ❑ LPG oulslde N.F.P.A. 704 HAZARD RATIt NOTE: Prrceo 4 Flammability nalLry �� In box Ileallh of Q Reacllvlly W Special I iazards -w- OX COR RAD rCIR This Chemical Inventory Report Form meals the reporting requirements of S.A.R.A. Tills III, Tier I) Repotilllg Form and the Uniform Fire Clodeall Thal Ap ly) Page _1_ of REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: C)fePSP (Yionkr #ytj CHEMICAL INVENTORY REPORT CHEMICAL DESCRIPTION Read ALL Instructions before completing form CAS NUMBER: LY1_I PRODUCT OR � �uQ> 3ABEL)14AME:�. nb `knd I66LnQi C- Ifnvns.Je Pl ❑ ❑ --El W I nc tr- in a nnLnnD Cnca;.t ee 7y ny mmsdlpl9 (ucultl) rr�r+w+v- Solid Liquid Gas Pure Mix W+ Delayed (chroNc) Is [his producl or any of Its Ingrodlenls on Ilia SARA EAlremoly Hazardous Substance (EHS) list? YES ® NO II"YES" Ilsl EHS Name: It "NO" Is It's chemical stored In amounts greater elan ,e,000 Ibs9 ❑ YES ENO CHEMICAL INGREDIENTS: TRADE SECRET: C� CAS Number: La 1 -q- 1 _ - S S - $ Percent of Mixture: 75 qe IngredlenlName: _ CAS Number: Ingredletil Name: CAS Number: Ingredlent Name: CAS Number: Ingredlenl Name: CAS Number: Irigredlent Name: Percent of Mixture: % Percent of Mixture: % Percent of Mixture: Percent of Mixture: % BLDG (Number or Address): INVENTORY AMOUNTS MAX. AVG. ON 014 SITE SITE Pounds �A"i'r'1'ltyl � CU.FI.SI"P S Gallons (use aclual quanlllles) SARA FORM p 002 Rev. 11-94 1 vyb\I Y STORAGE INFORMATION (Non-Confldenital) Storage Locations PEAK INVENTORY jSialernenl about how this chemical Is used: MONTH(S) 7 a 9 10D 11 2 I lieioair- Pry f I e i4ct HAZARD CLASSES TYf ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic CI Explosive ❑ Flammable_ Solid_ Gas ❑ Hazardous Waste ❑ Highly Toxic C,imbusE; lole, ❑ InfecllousAgents Uo d Irritants Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive ❑ Senslllzer ❑ Toxic ❑ Unstable (Reacllve) ❑ Water-Reacllve I FLAMMABLE/COMBUSTIBLE ❑ Class 1A Flash ❑ LIO lID': Class II 8 Class 18 Class 1.0 Point 115 , W Class IIIA Class 1118 Iti1Q(lIFIEDPETjiOLEUM �ASILPG. IP-GASI ❑ LPG In BLDGS -not accessible to public ❑ LPG In BLDGS -accessible to the public In 1-1.121conlalners LPG In public assembly buildings. LPG at conslrucllon slles. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place 0.4 Flarnmablllly, na0no �J in tux Health Q Reactivity Spaclal l lazards OX COR RAO This Chemical Inventory Report Form meats the reporting requirements of S.A.R.A. Title III, Tier II Reporting Form and the Uniform Fire Code. Illal Apply) Page �L of CHEMICAL INVENTORY REPORT REPORTING PERIOD From: JAN. 1, to: DEC. 31, FACILITY NAME: *=4Li CHEMICAL DESCRIPTION Read ALL Instructions before completing form CAS NUMBER: (-)3 IX'_1J2j_.g_ PRODUCTOR n LABEL)NAME: IfC(MQLMP-V4- i M°ckek 0 0 0 0 0 ftwterpr* Solid Liquid Gas Pure Mix Is this product or any of Its Ingredients on the SARA Extremoly Hazardous Substance (EHS) list? If "YES" list EHS Name: II "NO" Is Ilia chemical stored In amounts greater r than 10,0001t)s? lI CHE BLDG (Number or.Address): INVENTORY AMOUNTS MAX. AVG. ON ON �p(� SITE SITE o (g Pounds E CU.FI.STP Imnedute(a:utal 5 _70 Gallons D°lay°J (chrorec) (use actual quantities) YES PEAKINVENTORY NQ MONTH(S) 1 2 3 4 5 a 7 t3 910 It 12 YES ® N MICAL INGREDIENTS: TRADE SECRET: AS CNumber. I 1 0 7 — — — - a 1 - L Percent of Mlxlure:{-9 Ingredient Name: UAs Number: Ingredient Name: Number: Ingredient Name: _ CAS Number: Ingredient Name: CAS Number: . t Name: Percent of Mixture: % Percent of Mixture: Percent of Mixture: % Percent of Mixture: % SARA FORM N 002 Rev. 11-94 46 11 v STORAGE INFORMATION (Non-Conlldorillal) Storage Locations Statement about flow this chemical Is used: HAZARD CLASSES ❑ Aerosol Products ❑ Blasting Agent ❑ Carcinogen ❑ Corrosive pH ❑ Cryogenic ❑ Explosive ❑ Flammable _ Solid_ Gas ❑ Hazardous Waste ❑ Highly Toxic ❑ Infectious Agents on Irritants ❑ Non -Hazardous Chemical ❑ Organic Peroxide ❑ Other Health Hazard ❑ Oxidizer ❑ Pesticide ❑ Pyrophorlc ❑ Radioactive W Sensitizer ❑ Toxic ❑ Unstable (Reactive) ❑ Water -Reactive E FLAMMABLE/COMB (] Class 1A 1STIBl Flash E) E IO 11DS• Class II HClass1B Class 1C Point Q-12 [� class IIIA Class IIIB IJf�UIFIED PETROL ENM r•e�(LPG. LP- GAS1 ❑ LPG In BLDGS -riot accessible to public ❑ LPG In BLDGS -accessible to Ilia public In 1-LB containers LPG In public assembly buildings. LPG at construcllon slles. ❑ LPG outside N.F.P.A. 704 HAZARD RATING NOTE: Place 0.4 Flammability na tux �J ut Health p Reactivity Speclrll hlazards —W- OX COR RAD This Chemical Inventory Report Form meets the reporting requirements of S.A.R.A. Tills III, Tier it Reporting Form and the Uniform Fire Code II Iltal Apply) Page —I_ of _"L._ Preferred Developer May 9, 2006 Ms, Carie Dunn Poudre Fire Authority 102 Remington Street Fort Collin, CO 80524 RE: RIGDEN FARM, 8'H FILING, LOT 5, GREASE MONKEY & CAR WASH Dear Carie, In response to the Staff Project Review comment letter date April 25, 2006 from the City of Fort Collins, please accept the following hazardous materials information for the above mentioned project. The Grease Monkey is a franchised business, in which the owners are instructed to stock a particular amount of products to conduct business as outlined in the franchise agreement. The Car Wash business will not utilize any hazardous materials. I have attached Chemical Inventory Reports for all possible products and recommended quantities of the products. It is my understanding that these products are with in acceptable ranges of the S.A.R.A. and the Uniform Fire Code. Thank you for you assistance of this matter. Please feel free to call me with any questions you may have at 303-809-7766. Sincerely, Jody Newton AuTomonw DEVELOPMENT GRoup, LLG. 5 3 4 0 South Quebec Street, Suite 3 3 0 S Greenwood Village, CO 8 0 1 1 1 P ( 3 0 3 ) 2 2 1 - 0 0 7 1 F ( 3 0 3 ) 2 2 1 - 0 0 7 2