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(� FORM S - SAN L>E3 - AIS1PO COUNTY CERTIFIED UNIFIED (GRAM AGENCY
BUSINESS OWNER/OPERATOR IDENTIFICATION
I. IDENTIFICATION
FACILITY ID# 1 BEGINNING DATE 100 ENDING DATE 101
1 / 1 /06 1 12/31 /06
BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) 3 BUSINESS PHONEg2'S ,4.7 (aq 102
Hanson Aggregates (805)
BUSINESS SITE ADDRESS 103
131 Suburban Road
1oa CITY
San Luis Obispo CA ZIP CODE 93401 105
DUN & BRADSTREET 106 SIC CODE (4 digit N) 107
3273
COUNTY San Luis Obispo 108
BUSINESS OPERATOR NAME 109 1 BUSINESS OPERATOR PHO"4,1 ,
Hanson A2areeates (805) 5431MO
II. BUSINESS OWNER
OWNER NAME
11
OWNER PHONE 12 g — 3 7 101
112
Hanson Aggregates
{8fl5} �ro�
OWNER MAILING ADDRESS
113
131 Suburban Road
CITY
114 STATE 115 ZIP CODE
116
San Luis Obispo
1 CA 93401
1
III.
ENVIRONMENTAL CONTACT
CONTACT NAME !,
Steve &Il Lee, vUr _
117 1 CONTACT PHONE - ZS ;Z!+,4+ - 5$
11a
CONTACT MAILING ADDRESS
4 o o
119
CITY _ —
120 STATE 121 ZIP CODE y469 3
122
1
-PRIMARY- IV.
EMERGENCY CONTACTS -SECONDARY-
NAME
123
NAME
128
Hal Bradley
Carlos Garcia
TITLE
1za
TITLE
I29
Plant Manager
Batchman
BUSINESS PHONE
125
BUSINESS PHONE
130
(805) 221-2639
KS — 457 _1 b 5
24-HOUR PHONE
126
24-HOUR PHONE
PAGER N / C:
131
132
PAGER N 127
(I
133
ADDITIONAL LOCALLY COLLECTED INFORMATION:
Additional Secondary Contact: En , Business Phone: 8054V--2+9-1; Cell: SW
Rome Chr 5 VA r ctcvi1r NIG.r1.r ,e r -451-117
Certification: Based on my inquiry of those individuals responsible for obtaining the information, i certify under penalty of law that I have personally examined and
am familiar with the information submitted and believe the information is true, accurate, and complete.
SIGNAT $U E OOF OWN • IOPEPER�ATOR OR DESIGNATED REPRESENTATIVE DATE 134 1 NAME OF DOCUMENT PREPARER 135
J,�` 11/20/06 Steve Zacks
NAME OF SIGNER (print)
136 TITLE OF SIGNER 137
Steve Zacks Environmental Manager -
Page__ Of
£).o,,n r 01 1„�0-06� Ci'
cL
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
one page per material per building or area
❑ADD ❑DELETE OREVISE
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA — Doing Business As) HAN.SON AGGREGATES
CHEMICAL LOCATION A, CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY ID #
FA0002505
MAP# GRID#
(Agency use only)
II. CHEMICAL INFORMATION
CHEMICAL NAME
Daraset 400
TRADE SECRET []Yes ❑ No
If Subject toEPCRA,refer toinstructions
COMMON NAME Daraset 400
EHS* ❑Yes ❑ No
CAS#
*If EHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (Complete if required by CUPA)
Carcinogen (CARC), Irritant (Irr)
HAZARDOUS MATERIAL TYPE
[I(Check one item only) a. PURE 0 b. MIXTURE ❑ a WASTE
RADIOACTIVE ❑Yes ❑ No
CURIES
PHYSICAL STATE
a. SOLID 0 b. LIQUID 0 c, GAS
LARGEST CONTAINER 1500.0
(Check one item only)
FED HAZARD CATEGORIES a. FIRE ❑ b. REACTIVE ❑ PRESSURE RELEASE
❑ c. ®d. ACUTE HEALTH ❑ e, CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL WASTE AMOUNT
STATE WASTE CODE
700.0
1 1500.0
UNITS* @ a. GALLONS Q b. CUBIC FEET ❑ c. POUNDS ❑ d. TONS
DAYS ON SITE: 365.0
(Check one item only) *If EHS, amount must be in pounds.
STORAGE N a. ABOVE GROUND TANK e. PLASTIC/NONMETALLIC DRUM EF,. FIBER DRUM m, GLASS BOTTLE
CONTAINER [] b, UNDERGROUND TANK ❑ f. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE ❑ q RAILCAR
0 c. TANK INSIDE BUILDING ❑ & CARBOY ❑ k. BOX ❑ o. TOTE BIN ❑ r OTHER
Ia d. STEEL DRUM ❑ h. SILO ❑ 1. CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE 10 a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT
STORAGE TEMPERATURE 0 a. AMBIENT 0 b. ABOVE AMBIENT ❑ c, BELOW AMBIENT Q d. CRYOGENIC
%WT
HAZARDOUS COMPONENT (For mixture or waste only)
EHS
CAS #
1 50.0
Calcium nitrate
❑ Yes ® No
10124-37-5
2 5.0
Calcium nitrite
❑ Yes ® No
13780-06-8
3
5.0
Sodium thiocyanate
❑ Yes ❑ No
540-72-7
4
❑ Yes ❑ No
5
❑ Yes ❑ No
If more hazardous components are present at greater than 1 % by weight if non -carcinogenic, or 0.1% by weight if carcinogenic, attach additional sheets of paper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA. Please Si n Here
FORM I — SAN LUIS OBISPO COUNTY CERTIFIED UNIFIED PROGRAM AGENCY (CUPA)
CHEMICAL INVENTORY
nr
one ! per material per building or area)
[:]ADDDD ❑DELETE ItEViS E
I. FACILITY INFORMATION
BUSINESS NAME (Same as FACILITY NAME or DBA— Doing Business As) HAN.SON AGGREGATES
CHEMICAL LOCATION —
CHEMICAL LOCATION CONFIDENTIAL EPCRA
❑ YES ❑ NO
FACILITY ID #
FA0002505
MAP#
GRID#
(Agency use only)
H. CHEMICAL INFORMATION
CHEMICAL NAME
Da rava i r 1000
TRADE SECRET ❑ Yes ❑ No
If Subject to EPCRA, refer to instructions
COMMON NAME Daravair 1000
EHS* ❑Yes ❑ No
CAS#
*ITEHS is "Yes", all amounts below must be in lbs.
FIRE CODE HAZARD CLASSES (complete if required by CUPA)
HAZARDOUS MATERIAL TYPE
0 a. PURE M b. MIXTURE 0 c. WASTE
RADIOACTIVE ❑ Yes ❑ No
CURIES
(Check one item only)
PHYSICAL STATE
❑ a SOLID b, LIQUID 0 c. GAS
LARGEST CONTAINER 500.0
(Check one item only)
FED HAZARD CATEGORIES 0 a. FIRE ❑ b. REACTIVE ❑ c. PRESSURE RELEASE ® d. ACUTE HEALTH ❑ e. CHRONIC HEALTH
(Check all that apply)
AVERAGE DAILY AMOUNT
MAXIMUM DAILY AMOUNT
ANNUAL WASTE AMOUNT
STATE WASTE CODE
400.0
1 500.0
UNITS* Qi a. GALLONS Q b. CUBIC FEET ❑ c. POUNDS ❑ d TONS
DAYS ON SITE: 365.0
� 0
(Check one item only) *If EHS, amount must be in pounds.
.
STORAGE a. ABOVE GROUND TANK j3e. PLASTIC/NONMETALLIC DRUM ❑ i. FIBER DRUM m. GLASS BOTTLE
CONTAINER ❑ b. UNDERGROUND TANK ❑ f. CAN ❑ j. BAG ❑ n. PLASTIC BOTTLE ❑ q. RAIL CAR
❑ c. TANK INSIDE BUILDING ❑ g. CARBOY ❑ k. BOX ❑ o. TOTE BIN ❑ r. OTHER
❑ d. STEEL DRUM ❑ h. SILO [11. CYLINDER ❑ p. TANK WAGON
STORAGE PRESSURE 0 a, AMBIENT ❑ b, ABOVE AMBIENT ❑ c, BELOW AMBIENT
STORAGE TEMPERATURE 0 a. AMBIENT ❑ b. ABOVE AMBIENT ❑ c. BELOW AMBIENT 0 d. CRYOGENIC
%WT
HAZARDOUS COMPONENT (For mixture or waste only)
EHS
CAS #
I
N/A
❑ Yes ® No
z
❑ Yes ® No
3
❑ Yes ❑ No
4
❑ Yes ❑ No
5
❑ Yes ❑ No
if more hazardous components are present at greater than 1 % by weight if non -carcinogenic, or 0.1 % by weight if carcinogenic, attach additional sheets orpaper capturing the required information.
ADDITIONAL LOCALLY COLLECTED INFORMATION
If EPCRA Please Sign Here